Tag Archives: ex lap

General Surgery, Print Release, Trauma

PUBLISHED: Exploratory Laparotomy for Bowel Obstruction with Primary Repair of Two Diaphragmatic Hernias

Exploratory Laparotomy for Bowel Obstruction with Primary Repair of Two Diaphragmatic Hernias
Katherine H. Albutt, MD
Massachusetts General Hospital

A diaphragmatic hernia (DH) is characterized by protrusion of abdominal organs into the chest cavity through an opening in the diaphragm. A sliding or paraesophageal hernia is the most prevalent type, characterized by its occurrence near the esophageal hiatus. Typically present since birth, it can also develop later in life, occasionally arising as a result of severe trauma or iatrogenic injury. Less often, congenital DHs protrude through posterolateral or substernal diaphragmatic defects, referred to as Bochdalek and Morgagni hernias, respectively.

DH can remain asymptomatic and is commonly detected as an incidental finding during evaluation for other medical issues. Hiatal hernias differ from abdominal wall hernias in that they are influenced by the constant motion of the diaphragm, which exerts continuous friction and pressure changes on the esophagus and the stomach. As a result, hiatal hernias have a higher likelihood of recurrence following surgical correction in comparison to abdominal hernias.

This is the case of an exploratory laparotomy for bowel obstruction and primary pledgeted repair of two diaphragmatic hernias.

General Surgery, Print Release, Trauma

PUBLISHED: Exploratory Laparotomy in a Hemodynamically Stable Patient for an Abdominal Gunshot Wound

Exploratory Laparotomy in a Hemodynamically Stable Patient for an Abdominal Gunshot Wound
Matthew Daniel1; Ashley Suah, MD2; Brian Williams, MD2
1Edward Via College of Osteopathic Medicine – Auburn
2UChicago Medicine

Gunshot wounds to the abdomen are one of the most classic trauma cases a surgeon will come across in their career. The high velocity of a bullet can cause massive internal and external trauma to the abdomen. Exploration of the small bowel using laparotomy is often indicated after a penetrating traumatic injury or when peritoneal signs are present.

This video article shows the most common techniques for performing an exploratory laparotomy. In this case, the abdomen was explored and was revealed to show a through-and-through gunshot wound to the jejunum, as well as a partial-thickness tear of the proximal cecum; the abdomen was explored for any smaller bleeds or leaks, and the abdomen was closed.