INTRODUCTION
The
term laparotomy is derived from two Greek words: 'lapara' (meaning the
soft anterior part of the trunk between the ribs and the pelvic bone) and 'otomy'
(meaning making a surgical incision). Surgically, laparotomy is a procedure
involving making a large incision through the abdominal wall to gain access
into the abdominal cavity for diagnostic or therapeutic reasons.1
Exploratory laparotomy in itself is a surgical
operation performed on a patient who requires surgery but the actual cause and
nature of the disease is not known.1-3 On the other hand,
therapeutic laparotomy is done a known disease which requires operation for its treatment.2,3
Exploratory laparotomy is usually conducted as an emergency procedure in
patients who are acutely ill and require urgent operationfor control and
stabilization of their disease condition.1,4
The indications for exploratory
laparotomy are wide and varied. It is usually performed for cases of acute
abdomen which have not responded to conservative measures or have shown rapid
deterioration in patient's clinical condition.1-5 Indications may
include: blunt and penetrating abdominal traumas with associated haemodynamic
instability, bowel perforations, complicated inflammation of
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some intra-abdominal viscera, small and large bowel
obstructions, mesenteric ischaemia etc.1-5 Earlier before the advent
and wide spread use of current advanced imaging techniques, most patients
presenting with acute abdominal conditions underwent emergency surgical
exploration.5-7
However, with the improvement in the use of modern imaging
techniques and also with the current use of laparoscopy, the
n
e e d f o r e x p l o r a t o r y l a p a r o t o m y i s dwindling.2,5,8
Nonetheless, the importance and place of exploratory
laparotomy as a rapid and cost effective diagnostic and therapeutic tool
in
the management of some cases of acute abdomen is still very apt.2,4,5,9
The objective of this study is to appraise the common
indications for exploratory laparotomy in a General Surgery unit as well as to
assess the post-operative outcome and complications.
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