The management of penetrating abdominal trauma – challenging situations in emergency

Abstract

The paper is a retrospective study on a group of 97 patients admitted to the emergency room between 2012 to 2015 for suspicion of penetrating abdominal trauma. We have analyzed clinical data, paraclinical tests and how they correlate with therapeutic management. Out of the 97 patients, 78 presented penetrating stab wound. In 62 cases, immediate surgery was decided and 15 cases underwent seriated clinical and imaging follow-up. Of these, 3 patients underwent delayed laparotomy, for developing signs of peritonitis. The rate of non-therapeutic laparotomies was 9.72% (6 cases). Shock, peritonitis and evisceration were indications for immediate laparotomy. When the depth of the wound was uncertain, imaging tests (ultrasound, especially CT) provide valuable information for therapeutic management. Conservative treatment is an option for patients with no signs of hemodynamic instability and peritonitis, under careful clinical and paraclinical surveillance.

Keywords

• penetrating abdominal trauma
• laparotomy
• emergency
• management