Trauma laparotomy: evaluating the necessity of histological examination

Trauma laparotomy: evaluating the necessity of histological examination

Trauma laparotomy is the most commonly performed procedure in the acute care setting. As current practice, removed specimens are sent for histological examination. A retrospective review of all trauma laparotomies with specimens removed and sent to pathology during a 12-month period was performed in...

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Bibliographic Details
Published in:The American surgeon Vol. 75; no. 11; p. 1124
Main Authors: Laituri, Carrie, Teixeira, Andre, Lube, Matthew W, Seims, Aaron, Cravens, Jeremy
Format: Journal Article
Language:English
Published: United States 01-11-2009
Subjects:
Abdominal Injuries - pathology
Abdominal Injuries - surgery
Adult
Female
Follow-Up Studies
Histological Techniques - utilization
Humans
Laparotomy - methods
Male
Middle Aged
Retrospective Studies
Trauma Centers
Unnecessary Procedures
Young Adult
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Summary:Trauma laparotomy is the most commonly performed procedure in the acute care setting. As current practice, removed specimens are sent for histological examination. A retrospective review of all trauma laparotomies with specimens removed and sent to pathology during a 12-month period was performed in a Level I trauma center. One hundred five procedures of 244 trauma laparotomies yielded specimens sent for examination. Eighty-six patients were male and 19 patients were female with an average age of 34 +/- 14 years. Fifty-six per cent of the injuries resulted from penetrating trauma and 44 per cent were from blunt trauma. Gunshot wound and motor vehicle crash were the most common penetrating and blunt injuries, respectively. One hundred thirteen specimens were sent to pathology. Forty-three per cent of the specimens were spleen, 24 per cent small bowel, 16 per cent large bowel, 4 per cent kidney, 2 per cent omentum, 3 per cent appendix, 3 per cent pancreas, and 1 per cent for gallbladder and lung. One hundred twelve of 113 grossly normal specimens had normal pathology. One grossly normal specimen exposed abnormal pathology revealing benign appendiceal mucocele. Therefore, 99.1 per cent of grossly normal specimens sent for histological examination after trauma laparotomy were normal. Based on our review, in select patients routine histological examination of tissues removed for traumatic injury is unnecessary.
ISSN:0003-1348
DOI:10.1177/000313480907501120