Our study has similar rate of Splenectomy (22 cases) when compared to other studies of Yogesh et al (53%) followed by primary closure with Hepatorrhaphy. In our study, most common GIT surgery performed is resection and anastomosis similar to other studies.
of Percentage Patients Splenectomy 11 22 Hepatorrhaphy 8 16 Closure of perforation 7 14 Splenorrhaphy 4 8 Resection anastomosis 4 8 Drainage procedure 3 6 Splenorrhaphy and mesenteric 3 6 closure Mesenteric rent closure 2 4 Colostomy 2 4 Hepatorrhaphy and Mesenteric 1 2 closure Resection anastomosis and 1 2 mesenteric closure Hepatorrhaphy and Splenorrhaphy 1 2 Resection anastomosis and 1 2 pancreatic tube Hepatorrhaphy and closure of 1 2 perforation and resection anastomosis Table 4.
Splenectomy + hepatorrhaphy
was performed in 1 out of 3 patients with liver and spleen injuries; and splenorrhaphy + hepatorrhaphy
was performed in the other 2 patients.
oxidised cellulose/gelatin), suture hepatorrhaphy, perihepatic packing with temporary abdominal closure, and right hepatic artery ligation.
Suture hepatorrhaphy with topical haemostatic agents
Suture hepatorrhaphy and perihepatic packing###8 (7.07)
Perihepatic packing and suture hepatorrhaphy constituted our most frequently performed procedures.
Procedures done were repair of the colon (6 cases), small-bowel repair (12), combined small-bowel and colon repair (4), stomach repair and diaphragm repair (9), splenectomy (2), bladder repair (4), cholecystectomy and hepatorrhaphy
(2), non-remedial laparoscopy (8), and conversion to open (5).
study closure of bowel perforation was done in 13 patients, colostomy in 2 patients, repair of mesentery in 9 patients, splenectomy in 4 patients, splenorrhaphy in 1 patient and hepatorrhaphy in 6 patients; 50% of patients were managed conservatively, other 50% by operative methods; so compared to other studies the operative management was increased.
of Injured Procedure Patients Spleen Splenectomy Splenorrhaphy 10 2 Liver Hepatorrhaphy Haemostasis 2 2 and drainage Small bowel Primary closure Perforation 1 5 Resection and end-to-end anastomosis Rectum Hartmann's procedure 1 Mesentery Closure of tear with 1 resection of bowel and end-to-end anastomosis Diaphragmatic Hysterectomy 1 hernia with ruptured uterus Nonoperative 25 Management Table 8: Post-Operative Complications Post-Operative Complications No.
of patients Splenectomy 11 Hepatorrhaphy
3 Bowel perforation closure 20 Resection& anastomosis 10 Ileostomy/colostomy 5 Gastric perforation repair 5 (simple closure/modified grahams) Repair of mesentery 4 Post-operative complication includes wound infection(n=20),wound dehiscence(n=4), biliary leak(n=2), respiratory complication(n=2), intra-abdominal sepsis(n=2) etc.