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Combat casualties are frequently injured in austere settings where modern imaging modalities are unavailable. Exploratory laparotomies are often performed in these settings when there is suspicion for intra-abdominal injury. Given improvements in combat casualty care over time, we evaluated NTLs performed during later years of the wars in Iraq and Afghanistan.
An NTL was defined as a negative laparotomy without substantial intra-abdominal injuries requiring repair. Characteristics, indications for laparotomy, operative findings, and outcomes were examined. Among patients who underwent laparotomies, 41 Patients with NTLs had more computed tomography scans concerning for injury Patients with NTLs were also less likely to be admitted to the intensive care unit Our proportion of NTLs was lower than reported from earlier years during the wars in Iraq and Afghanistan.
No infectious complications from NTLs i. Nevertheless, surgeons should continue to have a low threshold for exploratory laparotomy in military patients in austere settings with concern for intra-abdominal injury. Keywords: Non-therapeutic laparotomy, Exploratory laparotomy, Combat trauma, Military, Surgical site infections.
In combat settings, penetrating trauma from explosive blasts and high-velocity gunshot wounds can often result in severe intra-abdominal injuries. Rapid diagnosis and management of abdominal trauma are crucial as delays can result in significant morbidity and mortality. Modern imaging modalities, such as computed tomography CT scans, are frequently unavailable in austere combat environments. Adjuncts, such as ultrasound or diagnostic peritoneal aspiration, can be helpful, but may result in equivocal findings.
