Background: Abdominal trauma is one of the leading causes of death. In Colombia, few studies have evaluated the results on related factors and outcomes when comparing laparotomy versus laparoscopy in the management of penetrating abdominal trauma. Therefore, the aim of this study was to investigate the feasibility and safety of laparoscopy in the treatment of stable penetrating abdominal trauma in a limited resources environment in a middle-income country.Methods: Retrospective cross-sectional study was conducted in Bogota, Colombia from January 2018 to October 2020. Patients over 18 years old, hemodynamically stable with penetrating abdominal trauma without other body parts injuries, that underwent laparoscopy and/or laparotomy surgical exploration and treatment were included. Frequencies, percentages, correlations, and odds ratio were calculated.Results: A total of 52 patients were analyzed (26 laparoscopy vs. 26 laparotomy).Stabbing injuries were more frequent in both groups (76.9%), as well as involvement of the anterior abdomen. None missed enterotomies were reported in the laparoscopy group. Surgical time and bleeding were significantly lower in the laparoscopic approach group (63 vs. 115 min and 65 vs. 992 cc, respectively).The time to oral intake and length of stay in the intensive care unit was significantly shorter in the laparoscopic management group (2 vs. 3 days and 1 vs. 4 days, respectively).Conclusions: Surgical results found a safe scenario in a limited resources environment for the application of the laparoscopic technique to approach penetrating abdominal trauma in stable patients without missed injuries, low threshold of conversion to open approach, and additionally not presenting a higher percentage of complications compared with the laparotomy group in Colombia.
Introducción. La hernia de Garengeot se caracteriza por contener el apéndice cecal dentro del saco femoral, y forma parte de una variedad de hernias que reciben el epónimo de acuerdo con su localización anatómica. Entre ellas se encuentra la hernia de Richter, la hernia de Amyand, la hernia de Littré y la hernia de Spiegel. Se presenta una revisión de los abordajes laparoscópicos para estas diversas variantes. Caso clínico. Paciente femenina de 82 años de edad quien consultó al servicio de urgencias por dolor inguinal derecho de ocho días de evolución, asociado a clínica de obstrucción intestinal. Se hizo diagnóstico de hernia inguinal encarcelada y se llevó a cirugía encontrando una hernia de Garengeot. Discusión. Además de los tipos de hernia tradicionalmente conocidos, existen variantes inusuales de hernias de la pared abdominal, que deben ser sospechadas y tenidas en cuenta como diagnóstico diferencial, lo que permitirá realizar su tratamiento de forma oportuna disminuyendo el riesgo de que ocurra una perforación intestinal. Conclusiones. Las variantes de hernia inguinal o de localización inusual, son susceptibles de tratamiento quirúrgico mediante abordajes laparoscópicos con adecuados resultados.
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