Acute Abdomen Requiring 14 Relooks and Five Months in ICU With a Favourable Outcome: A Report and Review of Literature.

An open abdomen or laparostomy is a lifesaving strategy used in critical situations to protect vital organs and stabilize patients before definitive closure of the abdominal incision. The indications for maintaining an open abdomen are broadly classified into two categories: the first is where it is impossible to close the abdomen due to bowel oedema and abdominal compartment syndrome (ACS), and the second is where there is a need for damage-controlled laparotomy or repeated intra-abdominal interventions. These open abdomens are frequently reported to require up to four relook laparotomies, and the open abdomen is commonly closed within 10 days. There are no reports in the literature regarding upper limits for relook relaparotomies or maximum duration of an open abdomen with a favourable outcome. We report a case of acute abdomen and severe bowel oedema, with the abdomen unable to be closed and kept open with a Bogota bag, requiring 14 laparotomies and multiple bouts of sepsis, requiring five months of intensive care therapy with a favourable outcome.