This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (16)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Mary C. McCarthy, MD; Gregory A. Lowdermilk, MD; David F. Canal, MD; Thomas A. Broadie, MD

Arch Surg. 1991;126(8):962-966.

Abstract
• Controversy about the appropriate evaluation of penetrating abdominal, flank, and back injuries prompted this retrospective review of 311 patients at an urban level I trauma center over 5 years. Seventy-five (24%) patients sustained gunshot wounds to the abdomen. All patients with gunshot wounds underwent exploratory laparotomy; results of 67 laparotomies (89%) were positive. Of 236 patients sustaining stab wounds (140 abdominal wounds, 51 flank wounds, 26 back wounds, and 19 wounds to multiple sites), 147 were treated according to a selective protocol, based on results of physical examination, wound exploration, peritoneal lavage, and ancillary diagnostic studies. No injuries were found at celiotomy in three (2%) of these 147 patients. One false-negative result of evaluation of a flank wound occurred. Significant injuries were found in 13 patients (68%) with stab wounds to multiple sites, 61 patients (44%) with abdominal stab wounds, 15 patients (29%) with flank stab wounds, and four patients (15%) with back stab wounds. Mandatory exploration of gunshot wounds is justified. Physical findings of intra-abdominal injury or positive results of peritoneal lavage identify stab wound victims likely to benefit from surgical exploration. A policy of mandatory observation or routine celiotomy for treatment of stab wounds is not justified.

(Arch Surg. 1991;126:962-966)

Author Affiliations
From the Indiana University Regional Trauma Center and Wishard Memorial Hospital, Indianapolis, Ind.

Footnotes
Accepted for publication April 28, 1991.

Read before the 98th Annual Meeting of the Western Surgical Association, Scottsdale, Ariz, November 12, 1990.

Reprint requests to Suite 7800, Center for Health Education, Miami Valley Hospital, One Wyoming St, Dayton, OH 45409 (Dr McCarthy).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Gunshot Wounds of Abdomen: Evaluation of Stable Patients with Triple-Contrast Helical CT
Munera et al.
Radiology 2004;231:399-405.
ABSTRACT | FULL TEXT  

Current technology: laparoscopic surgery in trauma
Brooks and Boffard
Trauma 1999;1:53-60.
ABSTRACT