Delayed Laparotomies in Blunt Injuries of the
Abdomen: Incidence Rates, Causes, Mortality Rates and Hospitalization Times in a Group of
139 Operated Patients. A Retrospective Study
Chmátal P., Kupka P., Vlasák V., Pavlovičová H.*
Chirurgické oddělení, Ústřední vojenská nemocnice Praha *Katedra aplikované matematiky, Přírodovědecká fakulta Univerzity Karlovy Praha |
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Summary:
Introduction: Employment of visualizing methods and achievements of conservative treatment methods have a major influence
on the management of blunt abdominal injuries. The aim of the study is to assess incidence rates of, possibly, delayed surgeries
and complications.
Patients and Methods: The authors conducted a retrospective analysis in a group of 139 operated patients. A common algorithm
was followed on their admission. The following parameters were assessed in patients operated later than 24 hours following
their admission (GROUP A): a cause of the delay, a mortality rate and duration of their intensive care unit (ICU) hospitalization.
The parameters were compared to those of a corresponding patient group operated no later than 4 hours after their
admission (GROUP B).
Results: The GROUP A included 17 (12.23%) patients. The delay median was 4 days (1–48). The diagnostics failed in 9
(52.94%), the conservative care failed in 8 (47.06%) subjects. The mortality rate was 29.41%. The GROUP B had significantly
higher survival rates (p-value 0.0445). There was no statistically significant difference in the parameters of the ICU hospitalization
duration.
Conclusion: Diagnostic conclusions of visualizing methods, including CT scans, cannot be fully relied on in blunt abdominal
injuries, mainly in cases of intestinal and diaphragmatic injuries. When a conservative treatment is indicated, the patient
has to be closely monitored while sustaining an active surgical approach.
Key words:
blunt abdominal injury – algorithm of the abdominal injuries management
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