Treatment of isolated penetrating flank trauma.
We present our experience during the past 5 years with isolated penetrating flank trauma. We examined the evaluation process, treatment plan, length of stay, outcome, and complications of patients with isolated penetrating injuries to the flank. There were four patient groups: 1) laparotomy (n = 5); 2) local wound exploration (n = 1); 3) laparoscopy (n = 8); and 4) observation and triple contrast CT scan (n = 9). All patients were male. The mean length of stay was 15 days for group 1, one day for group 2, two days in group 3, and 1.5 days in group 4. Three patients had diaphragmatic injuries, which were repaired laparoscopically. One patient with local wound exploration re-presented with a diaphragm hernia. A negative triple contrast CT scan resulted in no subsequent intervention. There were no missed injuries or complications from CT scan + observation or from diagnostic laparoscopy. We believe that laparoscopy may emerge as a useful adjunct in the treatment of patients with flank trauma. We present an algorithm for the management of penetrating flank trauma.
Dissanaike
Sharmila
S
Department of Surgery, Division of General Sur gery, Texas Tech University Health Sciences Center, MOP Build ing, Suite 380, 3502 9th Street, Lubbock, TX 79415, USA.
Griswold
John A
JA
Frezza
Eldo E
EE
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D000465:Algorithms; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008297:Male; D019370:Observation; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D036542:Tomography, Spiral Computed / Q000379:methods; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*