A Prospective Comparison of the Selective Observation and Routine Exploration Methods for Penetrating Abdominal Stab Wounds With Organ or Omentum Evisceration

Arıkan, Soykan; Kocakuşak, Ahmet; Yücel, Ahmet Fikret; Adaş, Gökhan

doi:10.1097/01.ta.0000152498.71380.3e

Cited by 70 publications

(61 citation statements)

References 26 publications

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“…In series where patients with penetrating injuries undergo routine explorative laparotomy, it has been shown that approxi- mately 30-50% of these patients do not actually require treatment (negative laparotomy) (21)(22)(23). In our study, the negative laparotomy rate was 28% and we believe this rate will decrease with more rigorous clinical and laboratory evaluation and perhaps with more effective use of diagnostic laparoscopy.…”

Section: Discussionmentioning

confidence: 60%

The conservative management of abdominal injuries

Okuş

Sevinç

et al. 2014

UCD

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Objective: Non-operative management of abdominal injuries has recently become more common. Especially nonoperative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of nonoperative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods:All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results:The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion:Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring.

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Section: Discussionmentioning

confidence: 60%

The conservative management of abdominal injuries

Okuş

Sevinç

et al. 2014

UCD

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“…The duration of hospitalization of 9 days of our patients does not differ from those found in the series varying between 5 and 9 days [23] [24].…”

Section: Comments-discussionmentioning

confidence: 60%

Traumatic Perforation of the Small Intestine in General Surgery of the CHU Gabriel Touré

Traoré¹,

Dembélé²,

Diakité³

et al. 2017

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Goal: To determine hospital frequency, to describe the clinical and therapeutic aspects and to determine the prognosis. Patients and Methods: This was a retrospective and prospective study carried out in the General Surgery Department from 1 January 1999 to 31 December 2015. Inclusion criteria: 1) open or closed trauma of the abdomen with perforation of the small bowel; 2) clinical examination (abdominal pain, vomiting, fever, abdominal contracture, evisceration, intraoperative findings); 3) paraclinical examinations: pneumoperitoneum on the abdominal X-ray without preparation (ASP) and CT scan. Exclusion Criteria: Abdominal trauma without perforation of the small bowel. We selected 128 patients operated for traumatic perforation of the small bowel. The data was entered and analyzed using Word, Excel 2007 and Statistical Package and Social Science Windows 16.0. The statistical analysis consisted in the calculation of the different frequencies of the variables studied. We used the Khi2 test with significance level P < 0.05. Results: We recorded 119 men versus 9 women and the sex ratio was 13.22. The mean age was 25 years with extremes varying between 15 and 70 years. The majority of patients 57.7% (74 cases) came from the capital, 46.1% (59 cases) were workers, 26.6% (34 cases) of the students. The average time to admission was 29 hours. The main etiologies were road traffic accidents 36.7% (47 cases), stabbing 21.9% (28 cases), firearm 14.8% (19 cases), and sports accidents 10.1% (13 cases). The main clinical signs were abdominal pain 48.44% (62 cases), abdominal contracture 60% (76 cases), disappearance of pre-liver dullness 66.36% (84 cases), and Douglas painful 74.4% (94 cases). The abdominal X-ray without preparation (A.S.P) allowed to objectify a pneumoperitoneum in 45.31% and the scanner a liquid effusion in 45.31% with the associated le-

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“…Операция при этом рассматривается и как диагностическая мани-пуляция, и как доступ для коррекции повреждений [14]. Но, как показывают многочисленные сообще-ния, проникающие ранения брюшной полости в 35-50% случаев не сопровождаются повреждени-ем органов [15][16][17][18][19][20][21][22][23][24][25][26][27]. В то же время после эксплора-тивной лапаротомии возможны опасные для жизни осложнения: спаечная кишечная непроходимость, психозы, пневмонии, гнойные осложнения, а в позд-ние сроки послеоперационные грыжи [22][23][24].…”

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Diagnostic and therapeutic potentials of laparoscopy in abdominal trauma

Панкратов¹,

Khatkov²,

Izrailov³

2015

Endosk. khir.

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A Prospective Comparison of the Selective Observation and Routine Exploration Methods for Penetrating Abdominal Stab Wounds With Organ or Omentum Evisceration

Abstract: The selective observation method is safe and superior to routine laparotomy for the treatment of penetrating abdominal stab wounds with omentum evisceration.

Cited by 70 publications

References 26 publications

The conservative management of abdominal injuries

The conservative management of abdominal injuries

Traumatic Perforation of the Small Intestine in General Surgery of the CHU Gabriel Touré

Diagnostic and therapeutic potentials of laparoscopy in abdominal trauma

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A Prospective Comparison of the Selective Observation and Routine Exploration Methods for Penetrating Abdominal Stab Wounds With Organ or Omentum Evisceration

Abstract: The selective observation method is safe and superior to routine laparotomy for the treatment of penetrating abdominal stab wounds with omentum evisceration.

Cited by 70 publications

References 26 publications

The conservative management of abdominal injuries

The conservative management of abdominal injuries

Traumatic Perforation of the Small Intestine in General Surgery of the CHU Gabriel Tour&#233;

Diagnostic and therapeutic potentials of laparoscopy in abdominal trauma

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Traumatic Perforation of the Small Intestine in General Surgery of the CHU Gabriel Touré