EP.FRI.466 Indications and Outcome of Abdominal Re-exploration in the Pediatric Population. A Single Centre Experience

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Abstract Abdominal exploration (ARE) is an important complication of abdominal surgery and has an effect on morbidity and mortality. ARE refers to exploration performed within 60 days following initial surgery. The purpose of this study is to know the grounds for performing re-exploration and its effects on the outcome. Methods This retrospective study was carried out in the pediatric surgery unit of Khyber teaching hospital from May 2017 to May 2019. All patients under the age of 16 years who underwent abdominal re-exploration within 60 days of the initial procedure were included in the study. Results A total of 55 re-exploration were done in the study duration of 2 years. The mean age of patients was 41 months (range of 0.06 to 168 months) male patients were 64%. On initial presentation, 56% of cases were emergency cases and 44% were elective. Common indications for re-exploration were, intestinal obstruction 29.1%, peritonitis 16.4%, complications of stoma 16.4%, burst abdomen 10.9%. The mean interval from initial surgery was 12.5±13.7 days. Common operative findings of re-exploration were inter-loop adhesions, anastomotic disruption, burst abdomen, anastomotic leak, intra-abdominal collection, gangrenous stoma, and para-stomal herniation. ARE resulted in 14.5% mortality. Conclusion Abdominal re-exploration is mainly indicated for intestinal obstruction and peritonitis. Inter loop adhesions and anastomotic leak are common surgical findings during re-exploration. The mortality rate is high in patients re-explored for peritonitis, fecal fistula, abdominal collection, and wound dehiscence.