SELECTIVE SURGERY AT THE ABDOMINAL STAB WOUNDS PENETRATING THE PERITONEUM

Abstract

Controversy continues about how to manage penetrating abdominal stab wounds. We have evaluated a prospective series of 65 patients with penetrating abdominal stab wounds. Patients were selected for conservative or surgical management on the basis of clinical findings. Laparatomy was performed on 37 patients (57%) remaining 28 patients (%43) were treated conservatively and discharged after an observation period. Signs of peritoneal irritation, evisceration of the bowel, shock, and pneumoperitoneum were laparatomy indications. In 14 laparatomies (21.5%), no intraabdominal injuries were found. There were various intraabdominal injuries in the remaining 23 laparatomies. Incidence of negative laparatomy has been reported to be 53-66 percent in the literature, when routine laparatomy was performed for stab wounds. In this study the rate of negative laparatomy was lowered to 21.5 percent and patients were saved from the risks of negative laparatomy. Selective laparatomy shortened the hospitalization time and hospital expenses have reduced.