Laparoscopic surgery in the management of traumatic hemoperitoneum in stable patients.
Unnecessary laparotomies in patients with abdominal traumatism (AT) who present hemoperitoneum with stable hemodynamics may be avoided if a diagnostic/therapeutic laparoscopy is performed. Between July 1992 and December 1994, 24 patients with AT and hemoperitoneum underwent this exploration: 5 were found to have a large retroperitoneal hematoma; 2, a tear in the intestinal mesenterium; 4, hepatic injuries; and 13, splenic lesions. Of the 24 patients, 9 needed conversion to open exploration: 8 during the laparoscopy and 1 shortly after operation. Mean hospital stay was 7 days (5-9). There was no morbidity or mortality in the series. Diagnostic/therapeutic laparoscopy is a method that is efficient and economical and can easily be undertaken by surgeons with experience in laparoscopy; it may be a valid alternative to conservative treatment or laparotomy in AT and hemoperitoneum patients who are hemodynamically stable.
Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, El Palmar, Spain.
J A
JA
Lujan-Mompean
P
P
Parrilla-Paricio
R
R
Robles-Campos
J A
JA
Torralba-Martinez
F
F
Sanchez-Bueno
J
J
Arenas-Ricart
D000007:Abdominal Injuries / Q000150:complications*; D000293:Adolescent; D000328:Adult; D005260:Female; D006439:Hemodynamics; D006465:Hemoperitoneum / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000293:injuries; D008297:Male; D008643:Mesentery / Q000293:injuries; D008875:Middle Aged; D013161:Splenic Rupture / Q000150:complications; D014949:Wounds, Nonpenetrating / Q000150:complications*