INTRA-ABDOMINAL PATHOLOGIES

Abstract

Objectives: To evaluate relative frequency, reasons, avoidable responsible factors and outcomes of relaparotomy. Study
Design: Observational case series study Setting: Department of Surgery Unit III BVH Bahawalpur Duration: From 01-9-2009 to 31-8-2010
Patients and Methods: All the patients who presented in surgical outdoor, indoor and casualty department with severe intra-abdominal
pathologies after primary laparotomies referred from low level, secondary care and tertiary care hospital and underwent relaparotomy electively
or on demand were included in the study. Retrospectively their demographic characteristics, initial diagnosis with surgical information of primary
laparotomy, factors and outcomes after relaparotomies were analyzed statistically. Results: A total 54 patients were included in the study with
male to female ratio of 1:2. Mean age of the study group was 30.91±12.5 years. Relative frequency of relaparotomy was 5.6%. Common center
of referral was low level hospital 66.7%.Most common indication of relaparotomy was peritonitis in 52%. Most common complication of
relaparotomy was wound infection 74%. Avoidable factors responsible for relaparotomies were found to be surgery at low level hospitals
(77.3%) and by nonqualified surgeons (72.1%). Conclusions: The rate of relaparotomy is very high because of unsupervised primary surgery
in institutions and surgery by unqualified operators in private sector. Many of these are avoidable. In addition to decreasing the complication
rate, primary surgery performed at tertiary care hospitals would decrease need for patients to undergo re-exploration.