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Frequency, indications and complications of midline laparotomy at a tertiary care hospital in Karachi

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Author(s): Zahid Memon | Irma Anis | Batool Fatima | Mustafa Abbas | Rabyyan Junaid | Sidra Mahmood

Journal: El Mednifico Journal
ISSN 2307-7301

Volume: 1;
Issue: 2;
Start page: 27;
Date: 2013;
Original page

Keywords: Laparotomy | Surgery | Complications | Civil Hospital Karachi | Pakistan

ABSTRACT
Background: Laparotomy is a rapid and cost-effective means of managing acute abdominal conditions and trauma. However, it can result in complications that cause considerable morbidity and mortality. The aim of our study was to determine the frequency, indications and common post-operative complications arising after midline laparotomies at a tertiary care hospital.Methods: This was a cross-sectional study carried out at Civil Hospital Karachi (CHK). All patients undergoing midline laparotomy at CHK between June, 2009 and November, 2010 were included. Their bio-data, mode of admission, time of surgery, indication for surgery and surgical findings were noted post-operatively. Daily follow up of all patients was done during their post-op hospital stay and appearance of early complications, if any, were noted. All surgical wards were visited regularly for 18 months (up to May 2011) to check for re-admittance of those patients due to any complication arising from their parent laparotomy.Results: A total of 384 patients underwent laparotomy during our study period. 262 (68.2%) were males and 122 (31.8%) were females. 121 males and 78 females developed complications. 340 (88.5%) laparotomies were conducted in emergency and only 44 (11.5%) were elective. 179 (62.6%) emergency cases developed 228 complications and 20 (45.5%) elective cases developed 28 complications. Most common indication for laparotomy was small intestinal perforation seen in 19.4% of emergency and 27.3% of elective cases. Wound infection, the most common complication, was responsible for 21.5% and 27.27% of the total complications of emergency and elective laparotomies respectively.Conclusion: Most of the laparotomies conducted are emergency in nature. Complication rate is very high in both emergency and elective cases.
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