A Retrospective Study of Emergency Laparotomies done in a Tertiary Care Centre of Mysuru

Abstract

Introduction: Compared to elective setting, poorer clinical outcomes are observed in laparotomy done in emergency. Nowadays interventional research designed to enhance the outcome, care and quality from emergency surgery is being done with respect to previous observational studies which just assess the outcome of surgery. To conduct research with optimal approach, there are no proper consensus. This study mainly focuses on intra operative presentation and postoperative complications in the patients presenting to tertiary care centre Perforation of hollow viscus is the commonest finding in patients underwent laparotomy. These conditions are of utmost significance as death of the patient might occur due to delay in timely surgical intervention. Following laparotomy, morbidity and mortality of patients depends on symptomatology, etiology, time gap between onset of symptoms and laparotomy, patient’s general condition and comorbidities, anaesthetic complications and postop care.Methods: This is a hospital-based retrospective study. Those patients who presented to our tertiary care centre with acute abdomen or trauma were included in our study. Study period was from 16 August 2020 to 15 August 2021, and the data were collected from hospital OT records from medical records department. It was conducted in accordance with the institutional guidelines.Results: This is a hospital based retrospective study of 77 emergency midline laparotomies done in our institute. Most of the patients belonged to the age group of 40–60-year. Around 93 % cases presented with acute abdomen , amongst which around 62% of them had gastrointestinal perforation. Around 90 % of the cases had pain abdomen as the most common presentation associated with other symptoms. Fever was the most common complication followed by wound infection. No complications were seen in 13 percent cases and mortality occurred in 13 percent cases.Conclusion: Early detection and immediate intervention with better postoperative care can minimise both morbidity and mortality associated with emergency laparotomy. To reduce both morbidity and mortality for patients who needs emergency intervention, it is of utmost importance to have public awareness, health education amongst public to get proper medical care, timely referral and mobilization of patient to a well equipped centre without any delay.