American Journal of Biological and Pharmaceutical Research

ABDOMINAL ABSCESS–A SEQUEL OF EXPLORATORY LAPAROTOMY FOR BLUNT TRAUMA ABDOMEN

Susnata De

drsusnata@gmail.com

Laparotomy, haemorrhagic, Trauma abdomen

Intraabdominal abscess has been a common complication following laparotomy in blunt trauma patients, carrying a high mortality rate. Association between occurrences of intra abdominal abscesses with laparotomies done for blunt abdominal traumas has been studied less frequently. In our study we tried to find out the incidence rate, their locations and severity. A retrospective review of 190 patients who underwent laparotomy was carried out over a period of two years. The incidences of intra abdominal abscesses are determined through clinical and radiological measures. Diagnosis was confirmed by Microbiological cultures. Of 190 patients who had laparotomy for blunt abdominal traumas we identified 32 (17 %) who had intra abdominal abscesses. The most common intra abdominal injuries involved the small bowel. Associated multiple extra abdominal injuries and high transfusion requirements increases the risk of intra abdominal abscess formation. Most of the intra abdominal abscesses were located in upper quadrants. Enterobacteracae sp. played most important role in formation of abscess. Out of 29 (15 %) mortalities following laparotomy 12 (6.4 %) were attributed to intra abdominal sepsis accounting upto 42.8 % of total mortalities. Poor prognostic features are multiple injuries, multiple organisms per abscess, blood 'and blood product transfusion, multiple organ failure. Intra-abdominal abscess is a common complication following laparotomy for blunt trauma abdomen. Multiple factors are responsible for its occurrence including multiple visceral truma, old age and delayed presentations. In spite of aggressive management this carries a high mortality rate.