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Laparotomy Due to War-Related Penetrating Abdominal Trauma in Civilians: Experience From Syria 2011-2017

Published online by Cambridge University Press:  03 June 2020

Bayan Alsaid Open the ORCID record for Bayan Alsaid [Opens in a new window] ,
Maryam Alhimyar Open the ORCID record for Maryam Alhimyar [Opens in a new window] ,
Ahmad Alnweilaty Open the ORCID record for Ahmad Alnweilaty [Opens in a new window] ,
Ehab Alhasan Open the ORCID record for Ehab Alhasan [Opens in a new window] ,
Zein Al Abidin Shalhoum Open the ORCID record for Zein Al Abidin Shalhoum [Opens in a new window] ,
Mustafa Bathich Open the ORCID record for Mustafa Bathich [Opens in a new window] ,
Ahmad Mustafa Ahmad Open the ORCID record for Ahmad Mustafa Ahmad [Opens in a new window] ,
Tareq Ahmad Open the ORCID record for Tareq Ahmad [Opens in a new window] ,
Khaled Turkmani Open the ORCID record for Khaled Turkmani [Opens in a new window]  and
Samer Sara Open the ORCID record for Samer Sara [Opens in a new window]
Bayan Alsaid*
Affiliation:
Department of General Surgery, Faculty of Medicine, University of Damascus, Syria
Maryam Alhimyar
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Ahmad Alnweilaty
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Ehab Alhasan
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Zein Al Abidin Shalhoum
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Mustafa Bathich
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Ahmad Mustafa Ahmad
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Tareq Ahmad
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Khaled Turkmani
Affiliation:
Faculty of Medicine, University of Damascus, Syria
Samer Sara
Affiliation:
Department of General Surgery, Faculty of Medicine, University of Damascus, Syria
*
Correspondence and reprint requests to Bayan Alsaid, Faculty of Medicine, Almazzeh Street, Damascus – Syria (e-mail: drbayan@gmail.com).
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Abstract

Objectives:

Penetrating abdominal trauma is one of the injuries that could affect civilians in wartime. This retrospective study investigates the commonly injured abdominal organs, and the impact of multiple injured organs on mortality.

Methods:

We reviewed the operating room (OR) logs of patients who presented to the surgical emergency department (SED) at Al-Mouwasat University Hospital with war-related abdominal penetrating trauma requiring exploratory laparotomy between April 1, 2011 and December 31, 2017.

Results:

Of 7826 patients with traumatic injuries, 898 patients (11.5%) required exploratory laparotomy. Of all patients who had an exploratory laparotomy (n = 898), 58 patients (6.5%) died in the perioperative period. Regarding complete laparotomies (n = 873 patients), small intestines, large intestines, and liver were the most commonly affected organs (36.4%, 33%, 22.9%, respectively). A total of 92 patients (10.2%) had negative laparotomy in which all the abdominal organs were not injured. The perioperative mortality rate (POMR) increased when more organs/organ systems were injured per patient reaching a peak at 3 organs/organ systems injuries with a POMR of 8.3%. POMR was highest in patients with musculoskeletal injuries (18.2%), followed by vascular injuries (11.8%), and liver injuries (7%).

Conclusions:

The management of civilians’ abdominal injuries remains a challenge for general and trauma surgeons, especially the civilian trauma team. The number and type of injured organs and their correlation with mortality should be considered during surgical management of penetrating abdominal injuries.

Keywords

abdominal traumadamage control surgery (DCS)perioperative mortality rate (POMR)Syrian armed conflict (SAC)Syrian war
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 15 , Issue 5 , October 2021 , pp. 615 - 623
Copyright
© 2020 Society for Disaster Medicine and Public Health, Inc.

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