The utility of diagnostic laparoscopy in the evaluation of anterior abdominal stab wounds.
BACKGROUND
To assess if diagnostic laparoscopy (DL) is superior to nonoperative modes (serial abdominal examination with/without computed axial tomography [CAT] and diagnostic peritoneal lavage) in determining the need for therapeutic laparotomy (TL) after anterior abdominal stab wound (ASW).


METHODS
Retrospective review of ASW patients. Patients were divided into group A (DL/exploratory laparotomy) to identify peritoneal violation (PV) and group B (initial nonoperative modes).


RESULTS
Seventy-three patients met inclusion criteria. In group A (n = 38), 29 patients (76%) had PV by DL and underwent exploratory laparotomy. Only 10 (35%) underwent TL (sensitivity for PV = 100%; specificity and positive predictive value of PV in determining need for TL = 29% and 33%, respectively). In group B (n = 35), 7 patients (20%) underwent TL, yielding an improved specificity (96%) and positive predictive value (88%).


CONCLUSIONS
We find no role for DL in the evaluation of ASW patients solely to determine PV.
Kopelman
Tammy R
TR
Division of Burns, Trauma Surgery and Surgical Critical Care, Department of Surgery, Maricopa Medical Center, Phoenix, AZ 85008, USA. tammy_kopelman@medprodoctors.com
O'Neill
Patrick J
PJ
Macias
Luis H
LH
Cox
Jordy C
JC
Matthews
Marc R
MR
Drachman
David A
DA
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014951:Wounds, Stab / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult