ROLE OF LAPAROSCOPY IN ABDOMINAL TRAUMA :A STUDY OF 50 CASES

Dr. ASHISH MOTEWAR

DEPARTMENT OF SURGERY,

GOVERNMENT MEDICAL COLLEGE,

NANDED - MAHARASHTRA

INTRODUCTION

COMMONLY USED DIAGNOSTIC MODALITIES FOR BLUNT ABDOMEN ARE :

- X-RAY

- USG

- CT SCAN

- DIAGNOSTIC PERITONEAL LAVAGE

RECENTLY USED - LAPAROSCOPY

MATERIAL AND METHODS

MATERIAL AND METHODS

- PERIOD : JAN. 2003 TO NOV. 2004

- NO. OF CASES : 50

- AGE GROUP : 10-50 YRS.

- SEX : MALE- 42, FEMALE- 08

- INVESTIGATIONS : X-RAY

USG

MATERIAL AND METHODS

PATIENTS WERE

HAEMODYNAMICALLY STABLE

AND CLINICALLY REQUIRED

EXPLORATION

MATERIAL AND METHODS

LAPAROSCOPY :

- 10 MM PORT AT UMBILICUS

- PNEUMOPERITONEUM WITH CO2

- 2nd AND 3rd PORTS INSERTED AS PER REQUIRMENT

MATERIAL AND METHODS

BLUNT TRAUMA

30 CASES

PENETRATING INJURIES

20 CASES

LAPAROSCOPIC FINDINGSINJURED CONTUSION LACERATION PERFORATION ORGAN

1. LIVER 02 03 --

2. SPLEEN 02 05 --

3. DUODENUM 01 -- 01

3. SMALL BOWEL 03 -- 04

4. MESENTRY 05 03 --

5. COLON 02 -- 02

ANTERIOR ABDOMINAL WALL HEMATOMA - 01

RETROPERITONEAL HEMATOMA - 02

LIVER : CONTUSION - 02, LACERATION - 03

LIVER : CONTUSION - 03, LACERATION - 05

SPLEEN : CONTUSION - 02, LACERATION - 05

SPLEEN :

EXPLORATION

WITH SUBCOSTAL

INCISION

DUODENUM : TRANSECTION - 01

DUODENUM : TRANSECTION - 01

ILEUM : PERFORATION- 04

ILEUM : CONTUSION- 03

ILEUM : CONTUSION- 03

ANTERIOR ABD. WALL HEMATOMA - 01

LAPAROSCOPIC FINDINGSINJURED CONTUSION LACERATION PERFORATION ORGAN

1. LIVER 02 03 --

2. SPLEEN 02 05 --

3. DUODENUM 01 -- 01

3. SMALL BOWEL 03 -- 04

4. MESENTRY 05 03 --

5. COLON 02 -- 02

ANTERIOR ABDOMINAL WALL HEMATOMA - 01

RETROPERITONEAL HEMATOMA - 02

SMALL & PROPER INCISION

4INCHES

CASES – 20

PROLAPSED BOWEL /

MESENTRY

PERFORATING INJURIES

OBSERVATION

- STOMACH -- 2

- SMALL BOWEL -- 2

- MESENTRY -- 1

- COLON -- 1

- NO INJURY -- 14

PERFORATING INJURIES

PRE-OP

POST-OP

PERFORATING INJURIES

RESULTS

LAPARATOMIES SAVED - 40

LAPAROTOMY REQUIRED - 10

CONCLUSION

- LAPAROSCOPY IS A BETTER MODALITY FOR DIAGNOSIS AND ASSESSMENT OF BLUNT INJURY ABDOMEN

- BLUNT ABDOMINAL INJURIES CAN BE TREATED WITH LAPAROSCOPY

- IF AT ALL LAPAROTOMY IS NEEDED IT CAN BE DONE WITH SMALL AND PROPER INCISION