Abstract
Six patients (five with abdominal trauma and one with strangulated ileus) who were in cardio-pulmonary arrest state on arrival underwent emergency room laparotomy for resuscitation at our hospital. All the six patients resumed heart beat. Of the six patients three (two with abdominal trauma and one with strangulated ileus and septic shock) were transferred to ICU and their lives saved temporarily. The one with the ileus recovered with stupor. The two patients with abdominal trauma eventually died with continuous bleeding at ICU. The remaining three with abdominal trauma died shortly after laparotomy with hemorrhagic or septic shock at the emergency room.
The indications of emergency room laparotomy for resuscitation are 1) cardio-pulmonary arrest or severe hemorrhagic shock induced by abdominal trauma, 2) cardio-pulmonary arrest induced by acute abdominal illness, and 3) a very limited time to rescue the patients and a critical time-loss by transporting them to a regular operation room.
To effectively perform the emergency room laparotomy it requires sufficient well-trained medical staff, and surgical equipment and instruments in the emergency room.
