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Abdominal stab wounds: a five-year patient review
1Academic Surgical Center Stuivenberg, University of Antwerp-UIA, Belgium.
Summary
Routine laparotomy is not always necessary for abdominal stab wounds. Diagnostic studies should guide surgical decisions, but exploratory laparotomy remains crucial if severe injury cannot be ruled out.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Surgical Diagnostics
Background:
- Abdominal stab wounds are a common emergency department presentation.
- The management of penetrating abdominal trauma has evolved, necessitating refined diagnostic approaches.
Purpose of the Study:
- To evaluate the necessity of routine exploratory laparotomy for abdominal stab wounds.
- To assess the efficacy of clinical and diagnostic methods in guiding surgical intervention.
Main Methods:
- Retrospective review of 101 patients treated for abdominal stab wounds over 5 years.
- Analysis of indications for exploratory laparotomy, including clinical assessment, ultrasound, paracentesis, and CT scans.
Main Results:
- Exploratory laparotomy was performed in 41 patients.
- Clinical investigation was the primary indication for laparotomy in 20 cases.
- Diagnostic imaging and paracentesis also guided surgical decisions in select cases.
Conclusions:
- Routine laparotomy for abdominal stab wounds is no longer universally warranted.
- Selective management guided by clinical evaluation and diagnostic studies is preferred.
- Exploratory laparotomy remains essential when severe injury cannot be excluded by diagnostic means.