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    • Role of Diagnostic Laparoscopy in Abdominal Trauma

    Osama G. Fahmy, Osama A. Radwan & Mohamed I. Monier
    Department of General Surgery, Laparoscopic and GIT Unit Maadi Military Hospitals

    Background: The role of laparoscopy in diagnosis as well as therapeutic interventions has increased markedly in the last few years. In trauma, it has become a viable alternative for the diagnosis of intraabdominal injury following penetrating and blunt trauma. The number of negative and/ or non-therapeutic laparotomies performed has decreased since the use of laparoscopy in diagnosis and management. Patients and Methods: Fifty patients with abdominal trauma (ten with blunt trauma, and forty with penetrating trauma) were selected from those attending the general surgery department of El-Maadi Military Hospital during period from 1/1/2013 to 1/1/2015. All patients were subjected to thorough clinical evaluation including history & physical examination. Full laboratory work up, ultrasonography, and computed tomography for the abdomen and the pelvis were performed. Diagnostic laparoscopy was done to all of them. Results: In the present study, diagnostic laparoscopy was successful in all patients (100%) and it was also therapeutic in seventeen patients (34%), negative in four patients (8%), non-therapeutic in three patients (6%), conversion to mini laparotomy in eight patients (16%) and conversion to full laparotomy in eighteen patients (36%). Patients with therapeutic laparoscopy and mini laparotomy were classified as eight patients with splenic lacerations (16%), seven with bowel injuries (14%), five patients with liver lacerations (10%), four patients with diaphragmatic injuries (8%) and one patient with stomach penetrations (2%). Patients managed by full laparotomy included ten patients with multiple organ injury (20%), four patients with fecal peritonitis (8%), one patient with multiple small bowel injury (2%), two patients with multiple retroperitoneal organ injury (4%) and one patient with uterine injury (2%). Conclusion: Laparoscopy can be performed safely and effectively in stable patients with abdominal trauma and it can deal with traumatic injury in a significant number of patients and can help to minimize laparotomy. Key words: Blunt trauma, Penetrating trauma, Laparoscopy, Laparotomy.

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