Clinical Outcomes of Exploratory Laparotomy in Children with Acute Abdomen: A Prospective Observational Study

Abstract

Abstract

Background: Acute abdomen is a common paediatric surgical emergency requiring prompt diagnosis and timely intervention. Exploratory laparotomy remains the definitive treatment for many life-threatening abdominal conditions in children.

Methods: This prospective observational study was conducted over 18 months (July 2024–December 2025) at the Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research. Fifty children aged 0–12 years presenting with acute abdomen and undergoing exploratory laparotomy were enrolled. Demographic characteristics, clinical presentation, laboratory and radiological findings, operative details, postoperative recovery, complications, and duration of hospital stay were recorded and analyzed.

Results: Infants aged less than one year constituted the largest age group (32.0%), with a mean age of 5.14 ± 4.16 years. Females accounted for 56.0% of the study population. Most children (78.0%) had normal nutritional status. Multiple air-fluid levels were the commonest radiological finding (34.0%). The mean duration of hospital stay was 9.64 ± 5.93 days. Most patients had satisfactory postoperative recovery; however, wound infection, wound dehiscence, prolonged ileus, and stoma formation were observed in a subset of children, particularly those presenting with perforation peritonitis, bowel gangrene, severe sepsis, delayed presentation, and poor nutritional status.

Conclusion: Exploratory laparotomy is an effective lifesaving procedure for children with acute abdomen. Early diagnosis, timely surgical intervention, adequate resuscitation, and meticulous perioperative care are essential to minimize postoperative complications and improve surgical outcomes.