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.
Lujan-Mompean
J A
JA
Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, El Palmar, Spain.
Parrilla-Paricio
P
P
Robles-Campos
R
R
Torralba-Martinez
J A
JA
Sanchez-Bueno
F
F
Arenas-Ricart
J
J
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*