[Aspects relevant for abdominal surgery of attempted suicide]

In this retrospective study of 24 patients who were treated at our clinic during the last 22 years after having attempted suicide, we evaluated aspects concerning abdominal- and transplantation surgery. There was a predominance of "hard" (70%) versus "soft" (30%) methods for suicide attempt. Intra-abdominal injuries resulting from attempted suicide by stabbing or shooting should lead to laparotomy-the prognosis is then good. Surgical treatment after intoxication, especially caustic ingestion, depends on endoscopic and clinical findings. The highly increased rates of suicide in patients with end-stage renal disease can be reduced significantly by kidney transplantation. The risk of suicide after transplantation is further diminished with improved immunosuppressive treatment. Only in a few cases there is an indication for liver transplantation-in some cases of fulminant hepatic failure caused by self-administered paracetamol overdose. Auxiliary liver transplantation may then be considered.