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Paper clip stab wounds: four case reports.

R M Lopez, M C McCarthy

Indiana Medicine : the Journal of the Indiana State Medical Association

|December 1, 1989

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Self-inflicted paper clip abdominal stab wounds in prisoners can be managed non-surgically. A strategy using physical exams, imaging, and wound exploration successfully avoided laparotomy in most cases.

Area of Science:

Trauma Surgery
Emergency Medicine
Forensic Medicine

Background:

Penetrating abdominal injuries (PAIs) management is debated, with selective vs. mandatory laparotomy approaches.
Self-inflicted wounds present unique challenges, including psychiatric factors and multiple injury attempts.

Observation:

Four prisoners sustained 22 self-inflicted abdominal stab wounds using paper clips.
These wounds mimicked peritoneal lavage needle entry and posed diagnostic difficulties due to potential intraperitoneal foreign bodies.

Findings:

A management protocol involving physical examination, abdominal films, and wound exploration with paper clip extraction was effective.
This approach successfully avoided the need for laparotomy in the majority of observed cases.

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Implications:

This strategy offers a viable alternative to routine laparotomy for specific self-inflicted abdominal injuries.
It highlights the importance of tailored management plans for unusual penetrating abdominal trauma scenarios.