Abstract
The surgical management of patients with abdominal trauma continues to evolve, from newer and better diagnostic methods to nonsurgical interventions to the surgical treatments themselves. As a consequence of improved quality of computed tomography, even complex injuries are increasingly being treated conservatively. The major challenge to the modern surgeon treating an acute traumatized patient is to determine whether or not the patient needs a laparotomy. Once decided to perform an early trauma laparotomy, the surgeon should be familiar with the principles of damage control and definitive anatomical care of the injuries identified, in accordance with many evidence-based standard protocols and guidelines. A careful intraoperative approach must be used in all patients in search for potential injuries, rather than concentrating simply on what is known to be injured. Negative laparotomies and missed abdominal injuries when they occur are still associated with significant complication rates and a prolonged length of stay.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Butt MU, Zacharias N, Velmahos GC (2009) Penetrating abdominal injuries: management controversies. Scand J Trauma Resusc Emerg Med 17:19
Como JJ, Bokhari F, Chiu WC et al (2010) Practice management guidelines for selective nonoperative management of penetrating abdominal trauma. J Trauma 68(3):721–733
Schroeppel TJ, Croce MA (2007) Diagnosis and management of blunt abdominal solid organ injury. Curr Opin Crit Care 13(4):399–404
Di Saverio S, Moore EE, Tugnoli G et al (2012) Non operative management of liver and spleen traumatic injuries: a giant with clay feet. World J Emerg Surg 7(1):3
Leppäniemi A, Haapiainen R (2003) Diagnostic laparoscopy in abdominal stab wounds: a prospective, randomized study. J Trauma 55(4):636–645
Casali M, Di Saverio S, Tugnoli G et al (2008) Penetrating abdominal trauma: 20 years experience in a Western European Trauma Center. Ann Ital Chir 79(6):399–407
Arikan S, Kocakusak A, Yucel AF et al (2005) A prospective comparison of the selective observation and routine exploration methods for penetrating abdominal stab wounds with organ or omentum evisceration. J Trauma 58(3):526–532
Tien H, Nascimento B Jr, Callum J et al (2007) An approach to transfusion and hemorrhage in trauma: current perspectives on restrictive transfusion strategies. Can J Surg 50(3):202–209
Duchesne JC, Barbeau JM, Islam TM et al (2011) Damage control resuscitation: from emergency department to the operating room. Am Surg 77(2):201–206
Waibel BH, Rotondo M (2012) Damage control surgery: it’s evolution over the last 20 years. Rev Col Bras Cir 39(4):314–321
Callum JL, Rizoli S (2012) Assessment and management of massive bleeding: coagulation assessment, pharmacologic strategies, and transfusion management. Hematology Am Soc Hematol Educ Program 2012:522–528
Haynes AB, Weiser TG, Berry WR et al (2009) A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 360(5):491–499
Marttos AC, Kuchkarian FM, Pereira BM et al (2012) Enhancing trauma education worldwide through telemedicine. World J Emerg Surg 7(Suppl 1):S4
Fraga GP, EspÃnola JP, Mantovani M (2008) Pericardial window used in the diagnosis of cardiac injury. Acta Cir Bras 23(2):208–215
Asensio JA, Demetriades D, Chahwan S et al (2000) Approach to the management of complex hepatic injuries. J Trauma 48(1):66–69
Fraga GP, Zago TM, Pereira BM et al (2012) Use of Sengstaken-Blakemore intrahepatic balloon: an alternative for liver-penetrating injuries. World J Surg 36(9):2119–2124
Selivanov V, Chi HS, Alverdy JC et al (1984) Mortality in retroperitoneal hematoma. J Trauma 24:1022–1027
Feliciano DV (1990) Management of traumatic retroperitoneal hematoma. Ann Surg 211(2):109–123
Hodgson NC, Malthaner RA, Ostbye T (2000) The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg 231(3):436–442
O’Dwyer PJ, Courtney CA (2003) Factors involved in abdominal wall closure and subsequent incisional hernia. Surgeon 1(1):17–22
Miller PR, Meredith JW, Johnson JC et al (2004) Prospective evaluation of vacuum-assisted fascial closure after open abdomen: planned ventral hernia rate is substantially reduced. Ann Surg 239(5):608–616
Dubose JJ, Scalea TM, Holcomb JB et al (2013) Open abdominal management after damage-control laparotomy for trauma: a prospective observational American Association for the Surgery of Trauma multicenter study. J Trauma Acute Care Surg 74(1):113–122
Hirshberg A, Wall MJ Jr, Allen MK et al (1994) Causes and patterns of missed injuries in trauma. Am J Surg 168(4):299–303
Haan J, Kole K, Brunetti A (2003) Nontherapeutic laparotomies revisited. Am Surg 69(7):562–565
Schnüriger B, Lam L, Inaba K et al (2012) Negative laparotomy in trauma: are we getting better? Am Surg 78(11):1219–1223
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
1.1 Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Rights and permissions
Copyright information
© 2014 Springer-Verlag Italia
About this chapter
Cite this chapter
Fraga, G.P., Rizoli, S. (2014). Trauma Laparotomy. In: Di Saverio, S., Tugnoli, G., Catena, F., Ansaloni, L., Naidoo, N. (eds) Trauma Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5459-2_1
Download citation
DOI: https://doi.org/10.1007/978-88-470-5459-2_1
Published:
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-5458-5
Online ISBN: 978-88-470-5459-2
eBook Packages: MedicineMedicine (R0)