{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:18:01Z","timestamp":1751516281972,"version":"3.41.0"},"reference-count":27,"publisher":"International College of Surgeons","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p>Diagnosis of intra-abdominal diseases in critically ill patients remains a clinical challenge. Physical examination is unreliable whereas exploratory laparotomy may aggravate patient's condition and delay further evaluation. Only a few studies have investigated the place of computed tomography (CT) on this hazardous situation. We aimed to evaluate the ability of CT to prevent unnecessary laparotomy during the management of critically ill patients. Charts of all consecutive patients who had undergone an emergency nontherapeutic laparotomy from 1996 to 2013 were retrospectively studied and patient's demographic, clinical characteristics, and surgical findings were collected. During this period 59 patients had an unnecessary laparotomy. Fifty-one patients had at least one preoperative imaging and 36 had a CT scan. CT scans were interpreted to be normal (n = 12), with minor anomalies (n = 10), or major anomalies (pneumoperitoneum, portal venous gas\/pneumatosis intestinalis, thickened gallbladder wall, and small bowel obstruction signs). Surgical exploration was performed through laparotomy (n = 55) or laparoscopy. Overall mortality was 37% with a median survival after surgery of 7 days. In univariate analysis, hospitalization in ICU before surgical exploration was the only factor related to death. In our series CT scans, objectively interpreted, helped avoid unnecessary surgical exploration in 61% of our patients.<\/jats:p>","DOI":"10.9738\/intsurg-d-13-00277.1","type":"journal-article","created":{"date-parts":[[2015,3,18]],"date-time":"2015-03-18T22:39:23Z","timestamp":1426718363000},"page":"466-472","source":"Crossref","is-referenced-by-count":2,"title":["How to Avoid Nontherapeutic Laparotomy in Patients With Multiple Organ Failure of Unknown Origin. The Role of CT Scan Revisited"],"prefix":"10.9738","volume":"100","author":[{"given":"Stephanie Li Sun","family":"Fui","sequence":"first","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato Micelli","family":"Lupinacci","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Tr\u00e9sallet","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"},{"name":"Universit\u00e9 Pierre et Marie Curie (Paris VI), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthieu","family":"Faron","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaelle","family":"Godiris-Petit","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harika","family":"Salepcioglu","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Severine","family":"Noullet","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrice","family":"Menegaux","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP-HP), Paris, France"},{"name":"Universit\u00e9 Pierre et Marie Curie (Paris VI), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"2","key":"i0020-8868-100-3-466-b01","series-title":"Surg Clin North Am","first-page":"307","article-title":"Acute mesenteric ischemia","volume":"77","author":"McKinsey\n              JF,","year":"1997","unstructured":"McKinsey\n              JF, \n            \n              Gewertz\n              BL. \n          \n          Acute mesenteric ischemia. 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