Clinical Outcome of Emergency Laparotomy: Our Experience at tertiary care centre (A case series)

Introduction: Laparotomy is broadly used for any surgery requiring opening of abdominal wall and exploration of the underlying structures. Elective laparotomy indirectly implies that there is ample time for preoperative assessment and preparation of the patient. On the other hand, an emergency laparotomy is a lifesaving procedure, undertaken mostly in acute cases, without much preparation of the patient. Materials and methods: This retrospective study included cases that underwent laparotomy for acute abdominal conditions between Jan 2013 to Jan 2014.We also studied the morbidity associated with each case and compared the results. Results: Morbidity and mortality after emergency laparotomy is high. This incidence increases in cases with associated co morbidities like COPD, asthma, diabetes mellitus, hypertension, pneumonia, renal failure. Out of 100 cases of emergency exploratory laparotomy performed 56 cases were due to hollow viscus perforation in which duodenal perforation was most common accounting for 28 cases. However, the maximum mortality rate was seen with gastric (26%) followed by ileal (10.5%), duodenal (10.5%), and jejunal and colonic perforations (5.25%). Conclusion: Most common condition for which emergency laparotomy was done was perforated peptic ulcer. The mortality and morbidity after emergency laparotomy is closely related to presence or absence of diabetes mellitus, hypertension, chronic renal impairment, cardiovascular disease (angina), asthma, liver disease, chronic obstructive pulmonary disease and metastatic disease and morbidity and mortality of patients who underwent emergency laparotomy is high when associated with these conditions.