Management of penetrating abdominal injuries

One hundred and twelve patients with penetrating abdominal injuries seen at the Kingston Public Hospital, Jamaica, over a twelve month period from January 1 to December 31, 1992 were reviewed. Seventy-five (67%) patients had stab wounds and thirty-seven (33%) sustained gunshot wounds. There were 10 deaths (27%) from gunshot wounds, and seven deaths (9%) due to stab wounds. Using a protocol of selective conservatism for stab wounds, 41 (60%) were observed, 27 (40%) explored and 5 (12%) patients had negative laparotomy. The male to female ratio was 10:1 with 88% in the age group 16-35 years. A decision to perform laparotomy was based entirely on clinical diagnosis of peritonitis. In gunshot wounds a policy of mandatory laparotomy was used and is recommended.