Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of General Surgery

Background: Abdominal shotgun injuries derive their significance from the wide range of injuries they cause. The management of this type of injuries has been continuously evolving. Despite the ongoing incorporation of laparoscopy in management of many penetrating injuries, there is no definite protocol raising the role of laparoscopy in such injuries. Aim of study:In this study, we plan to investigate prospectively the role of laparoscopy within a defined protocol for management of penetrating abdominal shotgun injuries focusing mainly on the safety of the procedure and its effect on hospital stay and subsequently hospital cost. Patients and methods: This study includespatients who attended to the emergency department at Kasr-Alainy hospital with a shotgun injury involving the abdomen from December 2014 to August 2016. After ensuring they were stable and with no symptoms or signs denoting a surgical abdomen, they would be included in this study. Abdominal CT would be performed to check for the presence of intra-abdominal pellets. If there was any pellet inside the abdomen by CT, the patient would be subjected to laparoscopic exploration.In patients with findings necessitating therapeutic intervention, conversion to laparotomy would be performed otherwise, they discharged home next day. We defined positive patients as the patients who had injuries that required further surgical interference only. All patients would be followed up one week and one month after discharge. Results:Our study included 30 patients; 27 males and 3 females with mean age 25. During laparoscopy, we identified 10 patients positive for injuries

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