title: The management of penetrating injuries of the back. A prospective study of 230 patients.
abstract: This is a prospective study of 230 patients with penetrating injuries of the back. The decision to operate or observe was taken exclusively on the abdominal physical findings. One hundred ninety-five patients (85%) did not require operation, 30 (13%) underwent a therapeutic laparotomy, four (1.7%) an unnecessary operation, and one patient (0.4%) had a completely negative laparotomy. The diagnosis and management was delayed in five (2.2%) patients with no serious consequences. Mortality rates were not recorded in this series. The initial physical examination was accurate in 95.2% of the patients. We suggest that penetrating injuries of the back should be assessed in the same way as anterior abdominal injuries. Physical abdominal examination is reliable in detecting significant intra-abdominal injuries.
authors.affiliation: Department of Surgery, Medical School, Johannesburg, South Africa.
authors.forename: D
authors.initials: D
authors.lastname: Demetriades
authors.forename: B
authors.initials: B
authors.lastname: Rabinowitz
authors.forename: C
authors.initials: C
authors.lastname: Sofianos
authors.forename: D
authors.initials: D
authors.lastname: Charalambides
authors.forename: J
authors.initials: J
authors.lastname: Melissas
authors.forename: C
authors.initials: C
authors.lastname: Hatzitheofilou
authors.forename: J
authors.initials: J
authors.lastname: Da Silva
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D000007:Abdominal Injuries / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D019567:Back Injuries; D003937:Diagnosis, Differential; D005260:Female; D006406:Hematoma / Q000175:diagnosis; D006801:Humans; D007422:Intestines / Q000293:injuries / Q000601:surgery; D007668:Kidney / Q000293:injuries / Q000601:surgery; D007813:Laparotomy; D008297:Male; D010179:Pancreas / Q000293:injuries / Q000601:surgery; D010808:Physical Examination; D011446:Prospective Studies; D012187:Retroperitoneal Space; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000601:surgery*