Role of diagnostic laparoscopy in blunt abdominal trauma

Abstract

Background: The appropriate treatment for patients with blunt abdominal trauma depends on the precise diagnosis of the presence and severity of intra-abdominal injuries. Laparotomy, however, has remained the management of choice in certain situations following blunt abdominal trauma such as in patients who have free intraperitoneal fluid of uncertain origin, signs indicating intestinal ischemia caused by mesenteric bleeding, and signs indicating hollow viscus perforation. The objective of the study is to determine the role of diagnostic laparoscopy in blunt abdominal injuries.Method: A prospective study was conducted in general surgery department in Sree Mookambika Institute of Medical Sciences, kulasekharam, Tamil Nadu., a tertiary care center including all patients with blunt trauma abdomen who underwent diagnostic laparoscopy during the time period from June 2019 to December 2020.Results: 27 males and 3 females were selected in this study. The most common mode of injury was vehicle collision. Out of 30 diagnostic laparoscopies,12 patients had solid organ injury, 5 patients had bleeding with no organ injury, 2 patients had mesenteric vascular injury, 2 patients had small bowel perforation. There were no findings in laparoscopy in 7 patients. Laparoscopy was converted to open Laparotomy in 3 patients. Therapeutic Laparoscopy were done in 20 patients.Conclusion: Laparoscopy can play an important role in diagnosis and treatment of blunt and penetrating trauma in hemodynamically stable patients. Low missed injury rates, reduced duration of hospital stay, faster recovery and reduced cost make it an attractive and safe alternative to classical trauma laparotomy.