Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings
Purpose Negative laparotomy in patients with abdominal penetrating injuries (APIs) is associated with deleterious outcomes and unnecessary expense; however, the indications for laparotomy in hemodynamically stable patients with ambiguous computed tomography (CT) findings remain unclear. This study a...
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2021-06-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://www.jtraumainj.org/upload/pdf/jti-2020-0058.pdf |
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| _version_ | 1841554969484853248 |
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| author | Eun Ji Choi Sanghee Choi Byung Hee Kang |
| author_facet | Eun Ji Choi Sanghee Choi Byung Hee Kang |
| author_sort | Eun Ji Choi |
| collection | DOAJ |
| description | Purpose Negative laparotomy in patients with abdominal penetrating injuries (APIs) is associated with deleterious outcomes and unnecessary expense; however, the indications for laparotomy in hemodynamically stable patients with ambiguous computed tomography (CT) findings remain unclear. This study aimed to identify the factors associated with negative laparotomy. findings Methods Data of patients who underwent laparotomy for APIs between 2011 and 2019 were retrospectively reviewed. Patients who presented with definite indications for laparotomy were excluded. The patients were dichotomized into negative and positive laparotomy groups, and the baseline characteristics, laboratory test results, and CT findings were compared between the groups. Results Of 55 patients with ambiguous CT findings, 38 and 17 patients were assigned to the negative and positive laparotomy groups, respectively. There was no significant difference between the groups with respect to the baseline characteristics or the nature of the ambiguous CT findings. However, the laboratory test results showed that there was a difference in the percentage of neutrophils between the groups (negative: 55.6% [range 47.4–66.1%] vs. positive: 79.8% [range 77.6–88.2%], p<0.001), although the total white blood cell count was not significantly different. The mean duration of hospital stay for the negative laparotomy group was 13.1 days, and seven patients (18.4%) experienced complications. Conclusions Diagnostic factors definitively indicative of laparotomy were not identified, although the percentage of neutrophils might be helpful. However, routine laparotomy in patients with peritoneal injuries could result in instances of negative laparotomy. |
| format | Article |
| id | doaj-art-d50ee1216a624006bfc38e2a79197f0b |
| institution | Kabale University |
| issn | 1738-8767 2287-1683 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-d50ee1216a624006bfc38e2a79197f0b2025-01-08T08:08:46ZengKorean Society of TraumatologyJournal of Trauma and Injury1738-87672287-16832021-06-0134211211810.20408/jti.2020.00581071Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography FindingsEun Ji Choi0Sanghee Choi1Byung Hee Kang2 Department of Surgery, Ajou University School of Medicine, Suwon, Korea Department of Surgery, Ajou University School of Medicine, Suwon, Korea Department of Surgery, Ajou University School of Medicine, Suwon, KoreaPurpose Negative laparotomy in patients with abdominal penetrating injuries (APIs) is associated with deleterious outcomes and unnecessary expense; however, the indications for laparotomy in hemodynamically stable patients with ambiguous computed tomography (CT) findings remain unclear. This study aimed to identify the factors associated with negative laparotomy. findings Methods Data of patients who underwent laparotomy for APIs between 2011 and 2019 were retrospectively reviewed. Patients who presented with definite indications for laparotomy were excluded. The patients were dichotomized into negative and positive laparotomy groups, and the baseline characteristics, laboratory test results, and CT findings were compared between the groups. Results Of 55 patients with ambiguous CT findings, 38 and 17 patients were assigned to the negative and positive laparotomy groups, respectively. There was no significant difference between the groups with respect to the baseline characteristics or the nature of the ambiguous CT findings. However, the laboratory test results showed that there was a difference in the percentage of neutrophils between the groups (negative: 55.6% [range 47.4–66.1%] vs. positive: 79.8% [range 77.6–88.2%], p<0.001), although the total white blood cell count was not significantly different. The mean duration of hospital stay for the negative laparotomy group was 13.1 days, and seven patients (18.4%) experienced complications. Conclusions Diagnostic factors definitively indicative of laparotomy were not identified, although the percentage of neutrophils might be helpful. However, routine laparotomy in patients with peritoneal injuries could result in instances of negative laparotomy.http://www.jtraumainj.org/upload/pdf/jti-2020-0058.pdfabdominal injurieswounds, penetratinglaparotomy |
| spellingShingle | Eun Ji Choi Sanghee Choi Byung Hee Kang Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings Journal of Trauma and Injury abdominal injuries wounds, penetrating laparotomy |
| title | Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings |
| title_full | Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings |
| title_fullStr | Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings |
| title_full_unstemmed | Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings |
| title_short | Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings |
| title_sort | indications for laparotomy in patients with abdominal penetrating injuries presenting with ambiguous computed tomography findings |
| topic | abdominal injuries wounds, penetrating laparotomy |
| url | http://www.jtraumainj.org/upload/pdf/jti-2020-0058.pdf |
| work_keys_str_mv | AT eunjichoi indicationsforlaparotomyinpatientswithabdominalpenetratinginjuriespresentingwithambiguouscomputedtomographyfindings AT sangheechoi indicationsforlaparotomyinpatientswithabdominalpenetratinginjuriespresentingwithambiguouscomputedtomographyfindings AT byungheekang indicationsforlaparotomyinpatientswithabdominalpenetratinginjuriespresentingwithambiguouscomputedtomographyfindings |