[Contribution of laparoscopy in the management of abdominal stab wounds]

Laparotomy is useless in 5 to 39% of patients suffering from penetrating abdominal trauma. The objective of this study is to try to determine the value of laparoscopy in the management of such patients. Thirteen patients underwent laparoscopy for abdominal wound. 11 of these patients had a penetrating abdominal trauma and only 4 of them suffered from lesions requiring surgical treatment (2 intestinal wounds, 1 gastric wound and 1 coeliac artery disruption). No treatment was required in 30 cases (1 wound of intestinal serosa and 2 superficial hepatic wounds). In the last 6 cases no intra-abdominal wound was found. There was no mortality or morbidity. No lesions were missed at laparoscopy. Laparoscopy avoided useless laparotomy in 9 out of 13 patients. This suggests that laparoscopy is a reliable method in the management of patients suffering from abdominal wounds, allowing a very sensitive and specific diagnosis of penetration and visceral injuries. In some cases, is allows laparoscopic treatment of the visceral injury.