Why laprotomy not required in right upper quadrant of abdomen gunshot wound?
The decision to perform an exploratory laparotomy depends on the patient’s status. If the patient is hemodynamically stable with normal BP, HR and hemoglobin level then emergent surgery may not be necessary. The liver is located in the RUQ and can lead to massive blood loss if injured. In penetrating injuries a laparotomy would usually be required to pack the liver to control the bleeding and make sure there are no other sources of bleeding. If the patient is stable on arrival to the hospital then a CT scan can be done to see the extent of the internal bleeding which can then help make the decision to take the patient to the OR. Ultrasonography (FAST exam) can also be done to see if there is internal bleeding.