Prospective Evaluation of the Role of Computed Tomography in the Assessment of Abdominal Stab Wounds

Inaba, Kenji; Okoye, Obi; Rosenheck, Rachel; Melo, Natália; Branco, Bernardino C.; Talving, Peep; Lam, Lydia; Reddy, Sravanthi; Salim, Ali; Δημητριάδης, Δημήτριος

doi:10.1001/jamasurg.2013.2521

Cited by 39 publications

(23 citation statements)

References 17 publications

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“…and Inaba et al . have questioned the necessity of CT scanning and argue that clinical assessment alone may be adequate for non‐operative management . However, this was not in effect when our protocol was first drawn up.…”

Section: Discussionmentioning

confidence: 99%

Non‐operative management of isolated single abdominal stab wound: is it safe?

Lee

Hauser

Jog

et al. 2018

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Non‐operative management of isolated single abdominal stab wound: is it safe?

Lee

Hauser

Jog

et al. 2018

ANZ Journal of Surgery

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“…[22]. Contrary, the operative decision will be assisted by imaging, preceded by wound exploration and repeated clinical examinations [23]. In pregnant women, even in cases of minor trauma, the clinical evaluation at the primary and secondary assessment should both look for non-obstetric, obstetrical and signs of fetal distress [12,18].…”

Section: Discussionmentioning

confidence: 99%

Abdominal stab wound in A Pregnant woman resulting in Evisceration, Uterine Perforation and Fetal Chest Injury: A Case Report and Literature Review

Oumarou¹,

Landry²,

Joe³

et al. 2019

J Surg Surgical Res

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Introduction: trauma is common in pregnancy; it affects one in twelve pregnancies. Abdomen represents the third anatomical region of the body most affected after the limbs and head. As pregnancy evolves, uterus increases in size and goes beyond the pelvic cavity; exposing the uterus to trauma and penetrating injuries in particular. Penetrating abdominal trauma in pregnancy requires a rigorous clinical evaluation to establish a complete assessment of obstetric and non-obstetric lesions. It is an obstetrical emergency whose management depends on the abnormalities found. In case of major trauma, it is essentially carried out in a trauma center, with a multidisciplinary team to improve the maternal and fetal prognosis.Case presentation: the authors report the case of a 28-year-old black woman, semi-Bantu, at 30 weeks gestation. She was referred to the emergency department of Douala Laquintinie Hospital for a penetrating wound of the abdomen after being stabbed at home. There were bowels protruding from the stabbed abdomen. The initial clinical assessment revealed hemodynamic instability, evisceration associated with bowel perforation, absence of active fetal movements, and absence of fetal heart sound from Doppler. An emergency laparotomy was performed. At the end of the surgical intervention, the following lesions were indentifi ed: penetrating wound of the abdomen with evisceration, intestinal perforation, uterine perforation, fetal penetrating chest injury and fetal death.Conclusion: this case report focuses on the spectrum of non-obstetric, obstetric and fetal injuries that may occur as a result of a penetrating stab wound in a pregnant woman.

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“…Nevertheless, potential risk of exposure to ionized radiation causing by CT should not be ignored [ 11 , 13 ]. Inaba et al [ 14 ] prospectively compared CT against serial physical examination in the evaluation of 249 patients with a stab wound to the abdomen. In their study, CT findings did not alter clinical decision making.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical observation and serial abdominal examination is a worldwide accepted approach to the patient with isolated abdominal SW [ 14 ]. Nevertheless it may not be appropriate in patients with multiple stab wounds due to relatively high probability of missing intra-abdominal injury.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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BackgroundManagement of stable patients with abdominal stab wound remains controversial, particularly for those with no clear indications for explorative laparotomy. We evaluated the risk of intra-abdominal injury in stab wound victims concomitantly stabbed in other anatomical body areas.MethodsWe performed a retrospective cohort study of patients with abdominal stab wounds recorded in the Israeli National Trauma Registry from January 1st, 1997, to December 31st, 2013. Patients with an isolated abdominal stab wound were compared to those with concomitant stab wounds to other anatomical areas. Intra-abdominal organ injury was defined by imaging or surgery findings. Multivariate analysis using a logistic regression model was conducted to assess independent risk for intra-abdominal organ injury.ResultsThe study included 3964 patients. After controlling for age, gender and hypotension on arrival, patients with multi-regional stab wounds had an increased risk of intra-abdominal injury (OR = 1.3, CI 95% 1.1–1.6, p < 0.001). These patients also had a higher rate of injury to the solid organs than patients with an isolated abdominal stab wound.ConclusionsPatients with multi-regional stab wounds have an increased risk of intra-abdominal injury. Worldwide accepted “clinical follow up” protocol may not be appropriate in management of patients with multi-regional stab wounds.

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Prospective Evaluation of the Role of Computed Tomography in the Assessment of Abdominal Stab Wounds

Cited by 39 publications

References 17 publications

Non‐operative management of isolated single abdominal stab wound: is it safe?

Non‐operative management of isolated single abdominal stab wound: is it safe?

Abdominal stab wound in A Pregnant woman resulting in Evisceration, Uterine Perforation and Fetal Chest Injury: A Case Report and Literature Review

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

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