CAN THE NEGATIVE LAPAROTOMIES DUE TO TRAUMA BE REDUCED?

The evaluation of patients with localized or general body trauma and laparotomy as the right decision during their therapy is one of the major problems for surgical emergency clinics. The term 'Explorative Laparotomy' is kept out of the explorative procedures within the time. Physical examination, vital findings, peritoneal lavage, the evaluation of the abdomen with the help of different imaging techniques and diagnostic are more guiding, when the surgeon plans to perform a laparotomy, and the number laparotomies is changing parallel to this. It is still not possible to reduce the rate of laparotomies to zero. In this study the cases, who were accepted to the surgical emergency clinic of our hospital because of wounds due to stabbing or gun firing or due to closed abdominal trauma, and the cases among these on whom negative laporotomies were performed, have been evaluated. It as been concluded that this rate (29%) can be reduced by having more laboratory support and with the help of the imaging techniques; but it has also been concluded that the second way should be preferred for the patient when we compare the morbidity of negative laparotomy and of delayed laparotomy.

TRAVMAYA BAÐLI NEGATÝF LAPAROTOMÝLER AZALTILABÝLÝR MÝ?

Bu çalýþmada 1996 yýlý içinde acil cerrahi kliniðine baþvurarak kesici delici alet veya ateþli silahlarla yaralanan yada kapalý karýn travmasý nedeniyle kabul edilen olgular ile bunlardan laparotomi yapýlanlar incelendi. Negatif laparotomi olgularý üzerinde dikkatle durularak, sebepleri araþtýrýldý. Görüntüleme yöntemleri ile laboratuvar desteðinin daha çok alýnmasý halinde bu oranýn (%29) düþebileceði belirlendi; ancak gecikmiþ laparotominin morbiditesi ile karþýlaþtýrýldýðýnda anýlan ikinci yolun hasta lehine her zaman tercih edilmesi gerektiði sonucuna varýldý.