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[Penetrating abdominal injuries].

A Nesbakken1, J Pillgram-Larsen, F Naess

  • 1Gastroenterologisk seksjon, Kirurgisk avdeling, Ullevål sykehus, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|February 28, 1990
PubMed
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This study of abdominal stab wounds found that immediate exploratory laparotomy is often unnecessary. Selective management, including local wound exploration, can safely confirm or exclude peritoneal penetration in many cases.

Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Surgical Outcomes

Context:

  • Review of 111 patients treated for abdominal stab wounds between 1980-1987.
  • Two hospitals serving a population of 450,000 people.
  • Stab wounds are infrequent in Norway, limiting surgeon experience.

Purpose:

  • To evaluate the efficacy and safety of immediate exploratory laparotomy versus selective management for abdominal stab wounds.
  • To analyze injury patterns and outcomes in patients with abdominal stab wounds.
  • To provide guidance on the management of suspected peritoneal penetration.

Summary:

  • Exploratory laparotomy was performed in 89 patients; 31 had negative findings or minor injuries with no complications.
  • Common injuries included liver lacerations, small bowel injuries, and diaphragm injuries.

Related Experiment Videos

  • Mortality rate was 2%; thoracic stab wounds below the fourth intercostal space require high suspicion for intraabdominal injury.

    • Impact:

    • Suggests selective management and local wound exploration can be a safe alternative to immediate laparotomy when evisceration is absent.
    • Highlights the importance of suspecting diaphragmatic and intraabdominal injuries in thoracic stab wounds below the fourth intercostal space.
    • Informs surgical decision-making for abdominal stab wounds, potentially reducing unnecessary laparotomies.