Patterns of Anterior Abdominal Stab Wounds and Their Management at Princess Basma Teaching Hospital, North of Jordan

Abstract

Hemodynamic instability and evisceration should continue to prompt urgent LAP. For stable patients, a sequence of LWE followed by focused abdominal sonography for trauma and computed tomography scanning for unclear cases primed by RCA was found to be efficient in limiting hospital admissions and reducing the rate of non-therapeutic LAP.

Frequency of intra-abdominal organ injury is higher in patients with concomitant stab wounds to other anatomical areas

“…Two thirds of all stab wounds patients in our study had violation of the abdominal cavity with or without intra-abdominal organ injuries. Similar findings have been reported in other studies [ 18 , 19 ]. However, the major finding of this work was a significantly higher incidence of most intra-abdominal organ injuries in patients with multiregional stab wounds.…”

Burden of Emergency Exploratory Laparotomies: Sleepless Nights in Operation Rooms

“…With advent of modern diagnostic modalities, the management of penetrating trauma has changed greatly in the past few years and many patients are now being managed conservatively. In a study conducted by Omari et al, stab wound caused fascial penetration in 253 patients and only 121 patients (48%) had to undergo therapeutic laparotomy (17).…”

Comparison between isolated serial clinical examination and computed tomography for stab wounds in the anterior abdominal wall

“…In the present, selective management is recommended by several scientific publications and it is adopted by most trauma centers. The safest protocol to improve diagnostic exams efficiency, minimize costs and reduce collateral effects is still debated in literature [3][4][5][6][7][8][9][10][11] . The goal, in special of diagnosis, is to recognize if there is abdominal penetration, and, if positive, if there is any lesion of an intra-abdominal structure.…”

“…Those 30 patients not submitted to surgery were discharged from hospital without complications. When SCE and CT isolated are compared, management results were very similar in terms of sensitivity, specificity, predictive values and accuracy(Table 4).Variability of protocols show that exact definition of management of these patients is still missing3,4,[6][7][8][9][10][11] . Most protocols propose wound exploration in hemodynamically stable patients without peritoneal signs, followed by early laparotomy, SCE, FAST or CT if peritoneal violation is present or in doubt cases.…”