Early Small Bowel Obstruction Following Laparotomy For Trauma
| Status: | Completed |
|---|---|
| Conditions: | Gastrointestinal |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | 15 - Any |
| Updated: | 5/13/2016 |
| Start Date: | January 2010 |
| End Date: | June 2010 |
Retrospective Review of the Incidence of Early Small Bowel Obstruction in Patients Undergoing an Exploratory Laparotomy Following Trauma
The formation of intraperitoneal adhesion following abdominal surgery is accepted by
clinicians as an inevitable consequence. More than 90% of patients undergoing a surgical
procedure in the abdomen will develop intraperitoneal adesions. The incidence however, of
small bowel obstruction (SBO) resulting form these adhesions is far lower. To date, it is
unknown which risk factors predispose these patients to develop SBO. Several have been
proposed, such as age, peritonitis, or surgery for small bowel injury resulting from
gunshots. None of them however, has been widely accepted.
During the last 20 years the significant lifetime risks associated with this phenomenon and
its impact on the quality of life of patients has been well recognized. In addition, the
burden on healthcare resources due to complications caused by adhesions is increasing and
medicolegal consequences are rapidly evolving.
Early SBO following laparotomy for trauma is a poorly described entity. A few retrospective,
single institution studies with a low number of patients have tried to address this issue.
However, these studies either included a subset of trauma patients, i.e. patients sustaining
penetrating trauma,[4] or patients undergoing a negative or non-therapeutic laparotomy, or
examined only the incidence of SBO requiring surgical intervention. In addition, recent data
regarding this issue is lacking, especially after the implementation of the damage control
concept and the other advances in trauma surgery.
The aim of this study is to define the incidence of early SBO following laparotomy for
trauma and to examine possible risk factors associated with its development.
clinicians as an inevitable consequence. More than 90% of patients undergoing a surgical
procedure in the abdomen will develop intraperitoneal adesions. The incidence however, of
small bowel obstruction (SBO) resulting form these adhesions is far lower. To date, it is
unknown which risk factors predispose these patients to develop SBO. Several have been
proposed, such as age, peritonitis, or surgery for small bowel injury resulting from
gunshots. None of them however, has been widely accepted.
During the last 20 years the significant lifetime risks associated with this phenomenon and
its impact on the quality of life of patients has been well recognized. In addition, the
burden on healthcare resources due to complications caused by adhesions is increasing and
medicolegal consequences are rapidly evolving.
Early SBO following laparotomy for trauma is a poorly described entity. A few retrospective,
single institution studies with a low number of patients have tried to address this issue.
However, these studies either included a subset of trauma patients, i.e. patients sustaining
penetrating trauma,[4] or patients undergoing a negative or non-therapeutic laparotomy, or
examined only the incidence of SBO requiring surgical intervention. In addition, recent data
regarding this issue is lacking, especially after the implementation of the damage control
concept and the other advances in trauma surgery.
The aim of this study is to define the incidence of early SBO following laparotomy for
trauma and to examine possible risk factors associated with its development.
This is a retrospective review of all trauma patients admitted to the Los Angeles County -
University of Southern California (LAC+USC) Medical Center from January 2006 to June 2009
(3.5 years). The trauma registry will be utilized to identify patients >= 15 years old who
underwent a laparotomy during the study period and survived > 72 hours. For patients meeting
inclusion criteria, all imaging studies obtained within the hospital course will be reviewed
to identify patients who developed early SBO. The rationale for utilizing imaging studies is
that obtaining these studies for patients with high suspicion of SBO is standard practice to
establish the diagnosis. The charts of these patients will subsequently be reviewed and data
will be collected using a predefined data collecting form.
University of Southern California (LAC+USC) Medical Center from January 2006 to June 2009
(3.5 years). The trauma registry will be utilized to identify patients >= 15 years old who
underwent a laparotomy during the study period and survived > 72 hours. For patients meeting
inclusion criteria, all imaging studies obtained within the hospital course will be reviewed
to identify patients who developed early SBO. The rationale for utilizing imaging studies is
that obtaining these studies for patients with high suspicion of SBO is standard practice to
establish the diagnosis. The charts of these patients will subsequently be reviewed and data
will be collected using a predefined data collecting form.
Inclusion Criteria:
- Exploratory laparotomy
- Survival > 72 hours
Exclusion Criteria:
- No exploratory laparotomy
- Survival <= 72 hours
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