CLINICAL ANALYSIS OF CASES IN WHICH LAPAROTOMY WAS PERFORMED FOR SEVERE ABDOMINAL PARENCHYMAL ORGAN INJURIES AT OUR HOSPITAL

Abstract

　　Objective : To investigate the indications for laparotomy for severe abdominal parenchymal organ injuries. Methods : We divided 19 cases of type III hepatic injuries, splenic injuries, or pancreatic injuries that were treated at our hospital from 2011 to 2015 into laparotomy and non-laparotomy groups. Results : Eight cases of hepatic injuries (2 of III a, 6 of III b), 9 cases of splenic injuries (3 of III a, 6 of III b), and 4 cases of pancreatic injuries (2 of III a, 2 of III b) were examined, and laparotomy was required in 10 cases. The indications for laparotomy were refractory shock in 5 cases, suspected abdominal contamination in 3 cases, and penetrating injury in one case. The remaining case involved a combination of type III b hepatic injury and type III a pancreatic injury ; however, the patient's vital signs were stable, making it difficult to judge whether a laparotomy was required. The laparotomy group tended to include more shock-on-arrival cases and have higher injury severity scores, but the differences were not significant. Conclusions : Although most patients that underwent laparotomy exhibited refractory shock or abdominal contamination as complications, possible bile leakage and/or pancreatic fistula formation may also require laparotomy.