An emergency laparotomy is a surgical operation that is used for people with severe abdominal pain to find the cause of the problem and in many cases to treat it. You will have a general anaesthetic and the surgeon will make an incision (cut) to open the abdomen (stomach area). Often the damaged part of an organ is removed and the abdomen washed out to limit any infection. An emergency laparotomy might be carried out for several reasons including bowel obstruction (blockage), bowel perforation (burst) and bleeding in the abdominal cavity (internal bleeding). These are conditions which if left untreated could be life-threatening. An emergency laparotomy is used either to save life or to limit illness, and in many cases it might be the only option available in order for the patient to get better.
- Use of an Early Warning Score (EWS) or lactate to identify patients most at risk for deterioration and the delivery of prompt resuscitation for these patients.
- Use of a sepsis screening tool to identify septic patients and treatment with Sepsis Six.
- Definitive surgery within 6 hours of decision to operate for patients categorized as Level 1 and 2a in urgency.
- Appropriate dynamic fluid resuscitation and optimization using goal-directed fluid therapy.
- Postoperative critical care (Level 2 or 3) for all patients.
- Consultant delivered care throughout the perioperative journey