Hemoperitoneum: Conservative Vs Operative Approach…A Dilemma

Hemoperitoneum: Conservative Vs Operative Approach: A Dilemma

Authors

  • Kaushal D. Suthar
  • Keshur J Varu

DOI:

https://doi.org/10.70284/njirm.v9i1.1852

Keywords:

conservative approach, criteria’s for approach, hemoperitoneum, mortality, morbidity

Abstract

Background: Haemoperitoneum should be open or not? - it is the dilemma that every surgeon come across whenever a case of hemoperitoneum arrives in emergency..!! Here we have tried to highlight the criteria which will be helpful in this regards. Aims & objective: This study was carried out to evaluate the results and to find out the criteria for decision-making for conservative or operative management in a case of hemoperitoneum.Methods:200 patients admitted during MAY 2014 TO MAY 2016 with hemoperitoneum were enrolled for the study and cases were evaluated for various variables like demographic data, injury classification, associated lesions, treatment, transfusions, morbidity and mortality, and hospital stay. Results: Out of total 200 patients, 76 patients was operated within 8 hours, out of which 22 patients underwent negative laparotomy. The remaining 124 patients were managed conservatively out of which 24 patients underwent laparotomy later because of the failure of the conservative management. Criteria which led to failure of conservative management and criteria which led to negative operative approach is discussed here. Conclusions: Conservative treatment is an adequate treatment in a great number of patients. Failure of conservative treatment did not show a higher incidence of complications or mortality but it should be performed in centers with experienced surgeons.

References

1. Ciraulo DL, Luk S, Palter M, Cowell V, Welch J, Cortes V, Orlando R, et al. Selective hepatic arterial embolization of grade IV and V blunt hepatic injuries: an extension of resuscitation in the nonoperative management of traumatic hepatic injuries. J Trauma 1998;45(2):353- 358; discussion 358-359
2. Richards JR, Schleper NH, Woo BD, Bohnen PA, McGahan JP. Sonographic assessment of blunt abdominal trauma: A 4-year prospective study. J Clin Ultrasound 2002;30:59–67.
3. Davis JJ, Cohn I, Nance FC. Diagnosis and management of blunt abdominal trauma. Ann Surg 1976; 183(6):672-8.
4. Kenneth D, Boffard, Bowley. Accident and emergency surgery. In: Russel RCG, Williams NS, Bulstrode CJK, edi, Bailey and Love’s short practice of surgery. 24th ed. London: Arnold publications. 2004. p. 270-86.
5. Farrath S, Parreira JG, Perlingeiro JA, Solda SC, Assef JC. Predictors of abdominal injuries in blunt trauma. Rev Col Bras Cir 2012;39(4):295-301
6. Bodhit AN, Bhagra A, Stead LG. Abdominal Trauma: Never Underestimate It. Case Rep Emerg Med 2011:850625.
7. Gourgiotis S, Vougas V, Germanos S, Dimopoulos N, Bolanis I, Drakopoulos S, Alfaras P, et al. Operative and nonoperative management of blunt hepatic trauma in adults: a single-center report. J HepatobiliaryPancreatSurg 2007;14(4):387-391.
8. Kozar RA, Moore JB, Niles SE, Holcomb JB, Moore EE, Cothren CC, Hartwell E, et al. Complications of nonoperative management of high-grade blunt hepatic injuries. J Trauma 2005;59(5):1066-1071.
9. Christmas AB, Wilson AK, Manning B, Franklin GA, Miller FB, Richardson JD, Rodriguez JL. Selective management of blunt hepatic injuries including nonoperative management is a safe and effective strategy. Surgery 2005;138(4):606-610

Downloads

Published

2018-02-28

How to Cite

Suthar, K. D., & Varu, K. J. (2018). Hemoperitoneum: Conservative Vs Operative Approach…A Dilemma: Hemoperitoneum: Conservative Vs Operative Approach: A Dilemma. National Journal of Integrated Research in Medicine, 9(1), 57–61. https://doi.org/10.70284/njirm.v9i1.1852

Issue

Section

Original Articles