[Penetrating wounds of the abdomen. Evaluation of conservative treatment in 40 cases].
Stabbed penetrating abdominal wounds are becoming more and more frequent in our emergency surgical unit due to increase of aggressions. The goal of our study is to evaluate the conservative treatment of these wounds. This concerns a study carried out between January 1997 and October 1998. Exploratory laparotomy was proposed at each time when one or more of the following criteria was noticed: choc, evisceration of intestines, digestive hemorrhagy or hematuria, outlet of digestive fluids, sign of peritoneal irritation, wounds by gunshots or wounds at the frontal regions. In the other cases, the conservative treatment with wound dressing following an antibiotic and serovaccination therapy of tetanus was the therapeutic option. Our study was carried out on 40 patients of whom were 37 males and 3 females of average age 24.9 years with extremities of 7 to 52 years. It arrived to the following results: 32 of the patients (80%) were victim of aggression and 29 cases were stabbed wounds. The wounds were in the central region (umbilicus 29.5%) and superior to the abdomen and were associated with outlet of the omentum (50%) outlet of the intestines (12.5%), peritoneal irritation (27.5%), digestive hemorrhagy (10%), hematuria (2.5%) outlet of faeces (2.5%). 17 patients (42.5%) underwent exploratory laparotomy on the basis of criteria afor mentioned and the 23 others (57.5%) underwent medical surveillance and 3 of them developed peritonitis and underwent surgery. The rate of negative laparotomy was 5% and retarded interventions was 13%. The morbidity was also 13% and mortality 2.5%. The average period of internship in hospital was 11,4 days with extremities of 1 to 101 days. The conservative treatment of penetrating stabbed abdominal wounds out of the criteria mentioned were quite satisfactory.
Fall
B
B
Clinique Chirugicale, CHU A. Le Dantec, Dakar, Senegal.
Ndiaye
A
A
Ka
O
O
Diop
P S
PS
Diao
B
B
D000007:Abdominal Injuries / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014950:Wounds, Penetrating / Q000628:therapy*