A prospective study of emergency laparotomies among patients attending Chengalpattu Medical College

INTRODUCTION: Emergency laparotomy is required for major intra-abdominal haemorrhage spontaneous or due to abdominal trauma and for infective, ischemic and obstructive condition in which gastric intestinal wall as a barrier is breached or threatened. Exploratory laparotomy is carried out in conditions where the need for an operation is recognized but where a definite diagnosis can be made only until the abdomen is opened. Emergency laparotomy is a high risk procedure which involves making an incision preferably in the midline to provide access to abdominal cavity and is associated with significant morbidity and mortality. Term also describes procedure for which the clinical presentation, pathology anatomical site, perioperative management vary considerably and immediate intervention is warranted to save the life of the patient. OBJECTIVES: A Prospective study of emergency laparotomies among patients attending Chengalpattu Medical College with acute abdomen and to know about its complications and management in our set up. METHODS: A PROSPECTIVE study of emergency laparotomies among patients attending Chengalpattu Medical College with acute abdomen and to know about its complications and management in our set up was conducted from October 2011 to September 2013. Study was conducted in to the incidence of complications among various patients and associated complication factors predisposing to such complications. Management of such risk factors could result in better prognosis and outcome in patient undergoing emergency laparotomies. CONCLUSION: 1. Acute abdomen was more common among 31 to 40 years group. 2. Male is to female ratio was 4:1. 3. Hollow viscus perforation was the most common cause for emergency Laparotomy. 4. Duodenal perforation was the single most common cause for emergency laparotomy. 5. Diverticulitis was the least common cause for emergency laparotomy. 6. Post-operative complication rate was 27%. 7. Post-operative mortality was 3%. 8. SSI is the most post-operative complication. 9. E. coli was the most common cause for SSI. 10. Post-operative myocardial ischemia had higher mortality. 11. Contaminated wound was the most common type in emergency laparotomies. 12. Hypoalbuminemia results in post-operative wound complications. 13. 20% albumin in the post-operative period resulted in early wound healing and reduced hospital stay. 14. Post-operative complications can be managed conservatively in 74%. 15. Surgical management needed only in 26% of complications