Diagnostic laparoscopy in the intensive care patient. Avoiding the nontherapeutic laparotomy
| Autor: | Marc L. Eckhauser, Paul P. Priebe, Christopher P. Brandt |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Ischemia Predictive Value of Tests Intensive care Laparotomy medicine Cholecystitis Humans Laparoscopy Abdomen Acute medicine.diagnostic_test business.industry General surgery Middle Aged Endoscopy Intensive Care Units Intestinal Diseases medicine.anatomical_structure Acute abdomen Predictive value of tests Abdomen Surgery Female medicine.symptom business Abdominal surgery |
| Zdroj: | Surgical endoscopy. 7(3) |
| ISSN: | 0930-2794 |
| Popis: | Evaluation of a potential acute abdomen in patients who require intensive care for concurrent medical/surgical problems is often difficult due to ambiguities in the physical exam and ancillary diagnostic tests. Between August 1990, and February 1992, 25 ICU patients underwent diagnostic laparoscopy to evaluate a suspected acute intraabdominal process. Thirteen laparoscopies were negative, and 12 were positive. The overall accuracy for laparoscopy was 96% as confirmed by subsequent laparotomy, autopsy, or clinical course. Laparoscopic findings led to a change in management in nine patients (36%), leading to earlier exploration in four patients, and avoidance of laparotomy in five. No significant hemodynamic effects were noted during laparoscopy, and the procedure-related morbidity was low (8.0%). Diagnostic laparoscopy is a safe and accurate guide for managing the ICU patient with a suspected acute surgical abdomen. The use of laparoscopy can help avoid nontherapeutic laparotomy or confirm the need for operative intervention in these complex cases. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink