Keywords
Exploratory laparotomy
Laparoscopy
Conservative treatment
Abdominal injuries
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Abstract
Objective: To analyze most common findings in exploratory laparotomy in abdominal trauma, in order to increase knowledge about injuries and their respective management. Literature review: Abdominal trauma has high morbidity and mortality. Among the most affected organs are the liver, spleen, kidneys, intestine and large vessels; and often the absence of obvious signs on physical examination makes the diagnosis difficult. In these patients, exploratory laparotomy is considered an effective method for investigation and treatment. Regarding massive viscus injuries, conservative treatment is the gold standard for hemodynamically stable patients, while for unstable patients, exploratory laparotomy is indicated. However, in suspected cases of hollow viscus injuries, regardless of stability, exploratory laparotomy is always mandatory. Even so, this therapeutic option presents risks inherent to both surgery and anesthesia; thus, negative laparotomy has disadvantages when compared to conservative treatment. Final considerations: The main findings show that laparoscopy surgery is superior to conventional exploratory laparotomy; in addition to evince fewer complications in conservative approaches, such as selective nonoperative management (SNOM) compared to surgical intervention, as long as correctly indicated.
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