Waqas Hasan Syed, Raheel Ahmad, Usman Qureshi, Jahangir Sarwar Khan, Salman Shafique, Faryal Azhar, Sarosh Afzal Farooqi.
Exploratory laparotomies in the emergency room: increasing burden and implications.
Rawal Med J Jan ;45(4):798-801.

Objective: To evaluate the spectrum of laparotomies in the emergency department of a tertiary care setup in Rawalpindi, Pakistan. Methodology: An observational retrospective study was conducted in Surgical Unit 1 of Holy Family Hospital, Rawalpindi, from June 2014 to April 2018. All patients undergoing midline exploratory laparotomy above 12 years of age, for trauma or non-traumatic reasons, were included in the study. Results: Out of 501 patients, 297 (59.28%) were males and 204 (40.72%) females. Majority (n=402, 80.2%) were non- traumatic causes of laparotomy. Peritonitis (58.2%) followed by intestinal obstruction (28.6%) were the most common indications of laparotomy in non-trauma patients whereas blunt trauma abdomen was the most common indication in trauma patients. Tumors and tuberculosis formed a minority of indication for laparotomy. Conclusion: In resource limited countries like Pakistan, we need more specialized centers at grass root level to share burden of emergency. Moreover, proper screening at primary and secondary level healthcare facilities may help decrease morbidity and mortality associated with tumors and tuberculosis presenting as acute abdominal emergencies.

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