[Penetrating abdominal trauma].
BACKGROUND
The abdomen ranks in third place of body areas injured by trauma. Evaluation and stabilization of these patients form the cornerstone in emergency medicine. Diagnostic approach and treatment outcome are influenced by several factors. Injury mechanism and pattern vary according to geography and there is an association with drugs and alcohol. Physical examination remains the most reliable indicator for surgery. Associated injuries are present in up to 26% of cases. We undertook this study to determine penetrating abdominal trauma incidence and frequency, demographic factors, rate of immediate and delayed laparotomies, and associated complications as well as to define the usefulness of penetrating abdominal trauma index (PATI).


METHODS
An observational, prospective, longitudinal descriptive study was carried out at the Hospital Central "Ignacio Morones Prieto," San Luis Potosi, Mexico from January 1, 2005 to December 31, 2005 on patients who underwent exploratory laparotomy for penetrating abdominal trauma. Twenty one variables were studied. Basic statistical analysis, ANOVA, chi(2) and Student's t-test were used.


RESULTS
Of the 79 patients who were included, 93.67% were males. The third decade of life was the most affected, with a night presentation being predominant as a result of personal violence. Drug use was observed in 50.6%; stab wounds in 63.3%. The most frequent locations were the left upper and right lower quadrants and epigastrium; solitary wounds were predominant. Associated injuries were most common in the thorax and limbs. Of the laparotomies performed, 92.4% were urgent and 60.53% were therapeutic; 15.19% required reoperations; complications were observed in 39.24%; and mortality rate was 3.9%.


CONCLUSIONS
Due to high non-therapeutic and negative laparotomies rates, a more selective approach is needed, including repetitive physical examination and the appropriate use of auxiliary diagnostic studies.
Pinedo-Onofre
Javier Alfonso
JA
División de Cirugía, Hospital Central Ignacio Morones Prieto, San Luis Potosí, México. dr_creatura@hotmail.com
Guevara-Torres
Lorenzo
L
Sánchez-Aguilar
J Martín
JM
D000007:Abdominal Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D004630:Emergencies; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012086:Reoperation; D019966:Substance-Related Disorders / Q000453:epidemiology; D013997:Time Factors; D019564:Unnecessary Procedures; D014754:Violence; D014781:Viscera / Q000293:injuries / Q000601:surgery; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D014951:Wounds, Stab / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery
D000900:Anti-Bacterial Agents