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Research article
Samer Ganam
Galilee Medical Center
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: During the Syrian civil war, casualties were treated on-site and only later transferred to foreign medical centers. Significant number needed abdominal re-operation. Our aim is to present our approach to abdominal trauma casualties who survived the on-site surgery and needed abdominal reoperation abroad.
Methods: Medical data from all medical records were retrospectively analyzed. Each patient underwent total body computerized tomography on arrival, revealing diverse multi-organ trauma. We divided the casualty population involving abdominal trauma into 4 sub-groups according to the location of abdominal surgical intervention, focusing on missed injuries and post-operative complications in the re-laparotomy sub-group.
Results: By July 2018, 236 casualties suffering abdominal trauma (among 1331 trauma casualties) had been admitted to our hospital. Life-saving abdominal interventions had been done in 138 subjects in Syria before arrival to our medical center. Seventy-nine underwent abdominal surgery in Israel, of whom, 46 (33.3%) needed abdominal re-laparotomy. Indications for re-exploration included severe peritoneal inflammation, neglected abdominal foreign bodies, hemodynamic instability and intestinal fistula. Mortality occurred in 37/236 patients, with abdominal trauma as the main cause of fatality in 10 of them (4.2%), usually following urgent re-laparotomy.
Conclusions: Clinical presentation of the Syrian casualties following emergency medical care outside our borders, and the fact that re-operation was not done by the same team responsible for the initial abdominal intervention posed major diagnostic challenges and necessitated increased suspicion and changes in our medical approach.
Keywords
Abdominal re-laparotomy, Damage Control surgery, Abdominal trauma, missed injuries, war casualties.
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Samer Ganam
Galilee Medical Center
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 07 May, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: During the Syrian civil war, casualties were treated on-site and only later transferred to foreign medical centers. Significant number needed abdominal re-operation. Our aim is to present our approach to abdominal trauma casualties who survived the on-site surgery and needed abdominal reoperation abroad.
Methods: Medical data from all medical records were retrospectively analyzed. Each patient underwent total body computerized tomography on arrival, revealing diverse multi-organ trauma. We divided the casualty population involving abdominal trauma into 4 sub-groups according to the location of abdominal surgical intervention, focusing on missed injuries and post-operative complications in the re-laparotomy sub-group.
Results: By July 2018, 236 casualties suffering abdominal trauma (among 1331 trauma casualties) had been admitted to our hospital. Life-saving abdominal interventions had been done in 138 subjects in Syria before arrival to our medical center. Seventy-nine underwent abdominal surgery in Israel, of whom, 46 (33.3%) needed abdominal re-laparotomy. Indications for re-exploration included severe peritoneal inflammation, neglected abdominal foreign bodies, hemodynamic instability and intestinal fistula. Mortality occurred in 37/236 patients, with abdominal trauma as the main cause of fatality in 10 of them (4.2%), usually following urgent re-laparotomy.
Conclusions: Clinical presentation of the Syrian casualties following emergency medical care outside our borders, and the fact that re-operation was not done by the same team responsible for the initial abdominal intervention posed major diagnostic challenges and necessitated increased suspicion and changes in our medical approach.
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