title: The role of laparoscopy in small bowel obstruction after previous laparotomy for trauma: an initial report.
abstract: Presently, there are no guidelines to help predict which patients are more likely to have successful laparoscopic adhesiolysis. We attempt to define which preoperative characteristics of trauma patients who later develop small bowel obstruction are most amenable to a laparoscopic operation. We did a retrospective review of all patients with small bowel obstruction after previous laparotomy for trauma. For the patients that received an operation to relieve the obstruction, the location of transition zone via CT scan and location of the previous abdominal scar were recorded. A previous upper abdominal surgical incision and a transition zone outside of the pelvis on CT scan were preoperative predictors of a successful laparoscopic adhesiolysis. The laparoscopic group had a shorter length of stay. Laparoscopic surgery as the initial operative approach in the management of SBO after previous laparotomy for trauma is safe and effective. Characteristics that make the laparoscopic approach most favorable are CT transition point above the pelvis and previous midline incision above umbilicus.
authors.affiliation: Division of Trauma and Surgical Critical Care Surgery, The University of Mississippi Medical Center, Jackson, Mississippi 39216, USA. drjonsimmons@gmail.com
authors.forename: Jon D
authors.initials: JD
authors.lastname: Simmons
authors.forename: Emily A
authors.initials: EA
authors.lastname: Rogers
authors.forename: John M
authors.initials: JM
authors.lastname: Porter
authors.forename: Naveed
authors.initials: N
authors.lastname: Ahmed
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult