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Abdominal exploration - series

Normal anatomy

The abdomen contains many vital organs: the stomach, the small intestine (jejunum and ileum), the large intestine (colon), the liver, the spleen, the gallbladder, the pancreas, the uterus, the fallopian tubes, the ovaries, the kidneys, the ureters, the bladder, and many blood vessels (arteries and veins).

Indication

The surgical exploration of the abdomen, also called an exploratory laparotomy, may be recommended when there is abdominal disease from an unknown cause (to diagnose), or trauma to the abdomen (gunshot or stab-wounds, or "blunt trauma").

Diseases that may be discovered by exploratory laparotomy include:

• inflammation of the appendix (acute appendicitis)
• inflammation of the pancreas (acute or chronic pancreatitis)
• pockets of infection (retroperitoneal abscess, abdominal abscess, pelvic abscess))
• presence of uterine tissue (endometrium) in the abdomen (endometriosis)
• inflammation of the Fallopian tubes (salpingitis)
• scar tissue in the abdomen (adhesions)
• cancer (of the ovary, colon, pancreas, liver)
• inflammation of an intestinal pocket (diverticulitis)
• hole in the intestine (intestinal perforation)
• pregnancy in the abdomen instead of uterus (ectopic pregnancy)
• to determine the extent of certain cancers (Hodgkin's lymphoma)

Incision

While the patient is deep asleep and pain-free (general anesthesia), the surgeon makes an incision into the abdomen and examines the abdominal organs. Different incisions are sometimes used depending on the circumstance. Common incisions include a vertical midline incision, and right or left upper or lower quadrant transverse incisions. Tissue samples (biopsies) can be taken and diseased areas can be evaluated. When the treatment is complete, the incision is closed with either sutures or skin staples.

Aftercare

The outcome from surgery varies with the disease process, as does the course and duration of recovery. Exploratory laparotomy is most commonly performed for trauma, severe abdominal pain of unknown cause, intestinal obstruction, inflammatory diseases like appendicitis and diverticulitis, and cancer of any of the abdominal organs.