Exploratory Laproscopy Case Study

LAPAROSCOPY IN PENETRATING ABDOMINAL STAB WOUNDS: DOES IT HAVE A ROLE???

Mohamed Riad (MD), Hatem Mohammed (MD), Yasser Hussein (MD), Mohammad Lotfy (MD).

General Surgery department Zagazig University

Abstract

Background: If the patient of penetrating abdominal stab wound is hemodynamically stable and has equivocal abdominal examination finding. Surgeons poses a significant challenge to take decision which favor of surgery or nonoperative conservative treatment. This decision requires a precise diagnosis that is not always possible with imaging techniques. In consequence of this circumstance; Laparoscopy can be a diagnostic or therapeutic tool in these cases. So that leads to avoid negative exploratory laparotomies.

Methods: It randomized

One case with small intestinal and mesenteric injury; the intestinal injury was managed with intra-corporeal suturing due to the wound size was small and the mesenteric injury also was small and controlled with clips used for laparoscopic cholecystectomy (additional 10 mm port was added in the supra-pubic region), and the 4th case was liver tear that was superficial and controlled with bipolar diathermy coagulation and compression by a piece of gauze for ten minutes. The other four cases who converted to open laparotomy.1st case complain from splenic injury which was near to the hilum with blood clot over it and open splenectomy was done. 2nd case complains from intestinal injury with big mesenteric injury with sign of ischemia appear at affected intestinal part; resection-anastomosis was done to affected part. 3rd case complains from colonic injury (transverse colon) with faecal soiling, in this patient colostomy was done at the perforation site. 4th case, he has a multiple small bowel perforation that needed resection-anastomosis of the affected