The Use of Laparoscopy in the Management of Trauma Patients: Brief review

El-Bendary, Yehia B. A.; Al-Adawi, Juhaina; Al-Qadhi, Hani

doi:10.18295/squmj.2016.16.01.003

Cited by 18 publications

(19 citation statements)

References 34 publications

(60 reference statements)

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“…Overlooked or delayed diagnosis are more common in cases with penetrating trauma etiology. [6] In our study, none of the patients developed postoperative mortality.…”

Section: Discussionmentioning

confidence: 44%

“…The mean postoperative hospital stay was 5±3.8 days. [5][6][7][8][9][10][11][12][13] An intraabdominal abscess developed in one patient postoperatively. No patients developed postoperative mortality.…”

Section: Resultsmentioning

confidence: 98%

“…Recent studies of diagnostic laparoscopy-related complications against negative laparotomy have shown that complication rates (3% versus 22%) and hospitalization time (1.4 days versus 5.1 days) were reduced. [6] The sensitivity of laparoscopy to the diaphragmatic injuries after penetrating trauma is 100%, specificity is 87.5% and negative predictive value is 96.8%. [7] Direct laparoscopic imaging of the diaphragm has been shown to be the best diagnostic method to identify diaphragmatic tears.…”

Section: Discussionmentioning

confidence: 98%

“…In contrast, laparoscopy is associated with less postoperative pain, faster recovery, and reduced wound complications. [6] Diagnostic laparoscopy should be performed to rule out diaphragmatic injury in left thoracoabdominal injuries. Since laparoscopy provides the possibility of simultaneous repair in patients with injuries, late complications related to injury can be prevented.…”

Section: Discussionmentioning

confidence: 99%

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Our Experience of Laparoscopic Surgery in Traumatic Diaphragmatic Injuries

Topal¹

2019

Laparosc Endosc Surg Sci

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Introduction: Diaphragmatic injuries are rare and occur in about 3% of all abdominal injuries. While 5% are caused by motor vehicle accidents, 10%-15% are caused by penetrating trauma. Diaphragmatic injury develops in 0.8%-7% of blunt trauma cases and 10%-15% of penetrating trauma cases. The aim of this study was to present a report of patients from a single center who underwent laparoscopic repair with the diagnosis of traumatic diaphragmatic injury during a 2-year period. Materials and Methods: Patients who underwent laparoscopic surgery at the study center due to traumatic diaphragmatic injury between May 2017 and November 2018 were included in the study. The demographic characteristics of the patients, cause of injury, additional injured organs, anatomical localization of the injury, surgical procedure, quantity of intraoperative hemorrhage, rate of conversion to open surgery, duration of hospitalization, morbidity and mortality rates, and 30-day readmission rate were retrospectively reviewed using hospital files and electronic records. Results: Of the patients enrolled in the study, 3 were female and 1 was male. The mean age was 47.25 years (range: 36-66 years). The injury etiology was penetrating injury for 3 patients and in-vehicle traffic accident for 1 patient. Two patients had a hemopneumothorax, which was treated with a chest tube. One patient displayed hematoma in the liver and spleen. The injury to the left diaphragm was 1-4 cm in diameter in all of the study patients. A primary repair was performed in all cases. The mean quantity of intra-abdominal bleeding was 212 mL (range: 100-300 mL) and the mean postoperative hospital stay was 7.5 days (range: 5-13 days). A postoperative intra-abdominal abscess developed in 1 patient. There was no instance of mortality and no patient was re-admitted in the 30-day period after discharge. Conclusion: It has been reported in the literature that laparoscopic approaches can be used safely in selected cases of abdominal injury, and can potentially have the benefits of laparoscopy. The results of this study also suggest that laparoscopy can be used safely in cases of traumatic diaphragmatic injury in the appropriate patients.

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“…Overlooked or delayed diagnosis are more common in cases with penetrating trauma etiology. [6] In our study, none of the patients developed postoperative mortality.…”

Section: Discussionmentioning

confidence: 44%

Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Our Experience of Laparoscopic Surgery in Traumatic Diaphragmatic Injuries

Topal¹

2019

Laparosc Endosc Surg Sci

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“…She also had splenic bleeding and a pneumothorax in the vicinity that likely impeded detection of the TDR. While multidetector CT imaging is more sensitive and specific than other imaging modalities for detecting diaphragmatic rupture [26], exploratory laparoscopy affords greater sensitivity and specificity [27,28] and should be considered for multitrauma patients whose symptoms are not explained by CT results. Had our patient's splenic rupture been treated surgically, the TDR may have been visualized and repaired before any symptoms of shoulder pain began.…”

Section: Discussionmentioning

confidence: 99%

Resolution of Chronic Shoulder Pain after Repair of a Posttraumatic Diaphragmatic Hernia: A 22-Year Delay in Diagnosis and Treatment

King

Skedros

Glasgow

et al. 2020

Case Reports in Orthopedics

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Diagnosing traumatic diaphragmatic rupture (TDR) due to penetrating rib fractures is challenging because the lesions are often too small to be detected and may present years after injury. Patients with delays in diagnosis of TDR rarely present with orthopaedic-related complaints of pain. We report the case of a 52-year-old female who presented with chronic left shoulder pain following a motor vehicle accident (MVA). In addition to left-side lower rib fractures, she also sustained a left-sided splenic laceration, pneumothorax, and two-part upper humerus fracture. Fracture treatment was percutaneous pinning; the other injuries were treated nonoperatively. Her shoulder pain could not be attributed to shoulder or neck pathology. Twenty years after the MVA, she began experiencing episodes of left-sided abdominal pain and nausea. A CT scan obtained two years later revealed a diaphragm hernia, which was repaired laparoscopically. Unique aspects of this case include (1) presentation to an orthopaedic surgeon with a chief complaint of chronic shoulder pain; (2) at 22 years, this is the fourth longest case of a delay in diagnosis of TDR; and (3) the unique symptom of ipsilateral referred shoulder pain, which immediately improved after hernia repair.

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The Role of Diagnostic Laparoscopy in the Evaluation of Abdominal Trauma Patients: A Trauma Quality Improvement Program Study

et al. 2023

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Purpose We aimed to identify factors related to delayed intervention in abdominal trauma patients who underwent diagnostic laparoscopy using a nationwide databank. Methods From 2017 to 2019, abdominal trauma patients who underwent diagnostic laparoscopy were retrospectively evaluated using the Trauma Quality Improvement Program. Patients who underwent delayed interventions after a primary diagnostic laparoscopy were compared with those who did not. Factors associated with poor outcomes that are usually correlated with overlooked injuries and delayed interventions were also analyzed. Results Of the 5221 studied patients, 4682 (89.7%) underwent inspection without any intervention. Only 48 (0.9%) patients underwent delayed interventions after primary laparoscopy. Compared with patients receiving immediate interventions during primary diagnostic laparoscopy, patients receiving delayed interventions were more likely to have small intestine injuries (58.3% vs. 28.3%, p \ 0.001). Among patients with hollow viscus injuries, a significantly higher probability of overlooked injuries that required delayed intervention was observed in patients with small intestine injuries (small intestine injury: 16.8%; gastric injury: 2.5%; large intestine injury: 5.2%). However, delayed small intestine repair did not significantly affect the risk of surgical site infection (SSI) (p = 0.249), acute kidney injury (AKI) (p = 0.998), or hospital length of stay (LOS) (p = 0.053). In contrast, significantly positive relationships between delayed large intestine repair and poor outcomes were observed (SSI, odds ratio = 19.544, p = 0.021; AKI, odds ratio = 27.368, p \ 0.001; LOS, b = 13.541, p \ 0.001). Conclusions Most examinations and interventions (near 90%) were successful during primary laparoscopy for abdominal trauma patients. Small intestine injuries were easily overlooked. Delayed small intestine repair-related poor outcomes were not observed.

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The Use of Laparoscopy in the Management of Trauma Patients: Brief review

Cited by 18 publications

References 34 publications

Our Experience of Laparoscopic Surgery in Traumatic Diaphragmatic Injuries

Our Experience of Laparoscopic Surgery in Traumatic Diaphragmatic Injuries

Resolution of Chronic Shoulder Pain after Repair of a Posttraumatic Diaphragmatic Hernia: A 22-Year Delay in Diagnosis and Treatment

The Role of Diagnostic Laparoscopy in the Evaluation of Abdominal Trauma Patients: A Trauma Quality Improvement Program Study

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