Trauma laparotomy + Splenectomy
Trauma laparotomy is a surgical approach warranting an emergency invasion of the
abdominal cavity following the reporting of blunt and penetrating abdominal trauma (Salotto
& Jurkovich, 2017, p. 523). The preliminary objectives of trauma laparotomy approach are
based on the repair of deteriorated abdominal regions or organs, management of
gastrointestinal contamination, and haemorrhage control. The surgeon requires adopting a
time-sensitive and comprehensive approach for resolving the abdominal injuries through the
execution of single or multiple surgical phases. The trauma laparotomy approach focuses on
resolving the immediate threats to the patient’s life. For example, the effective control of
heavy bleeding or exsanguination followed by resuscitation interventions facilitate the
patient’s recovery process inside the operation theatre. The resuscitation interventions include
physiologic insult’s counterbalancing, coagulopathy treatment, intravascular volume
maintenance, and fluid/blood product administration. Splenic injuries substantiate the
requirement of laparotomy intervention in the context of removing the injured splenic
portion. Splenectomy requirement in most cases is based on the management of splenic
bleeding following the occurrence of penetrating trauma
(The_American_Association_for_the_Surgery_of_Trauma, 2012). The presented essay
effectively discusses pre-operative, intraoperative, and postoperative phases of laparotomy
and splenectomy in the context of blunt splenic injury. The essay also discusses the patient’s
physiology, anatomy and their implications on the pre/intra/post-operative management. The
essay addresses trauma-based adult versus paediatric splenectomy, anaesthetic management,
clinical complications, and situational awareness of trauma laparotomy.
The trauma laparotomy intervention requires surgical invasion through the anterior
abdominal wall into the abdominal cavity (Rajaretnam & Burns, 2019). The abdominal wall
encapsulates the abdominal viscera and abdominal cavity that warrant systematic invasion
followed by the reported occurrence of blunt abdominal trauma. The trauma laparotomy
intervention warrants a systematic invasion of the anterior abdominal wall components
including peritoneum, transversalis fascia, pyramidalis muscle, transverse abdominis muscle,
rectus abdominis muscle, internal oblique muscle, and external oblique muscle. Other
significant components include Scarpa fascia, Camper fascia, subcutaneous fat, and skin
(MacKay & Varacallo, 2019). The rectus abdominis muscle bifurcates through linea alba
across pubic symphysis and xiphoid process. The rectus abdominis collaborates with 7, 6, and

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Trauma Laparotomy and Splenectomy: Management and Complications

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