title: Patterns of anterior abdominal stab wounds and their management at Princess Basma teaching hospital, North of Jordan.
abstract: BACKGROUND
  With the progressive use of new diagnostic techniques, the management of penetrating abdominal stab wounds is changing. Most studies have been conducted in well-equipped trauma centers in developed countries, and there is a paucity of reports from general teaching hospitals with limited resources. We reviewed the assessment of anterior abdominal stab wounds in patients presenting to our hospital hoping to establish an evidence-based algorithm for managing such patients in busy general hospitals.
  
  
  METHODS
  The medical records of all 393 patients treated at our hospital for anterior abdominal stab wounds over a 7-year period were reviewed. Information regarding age, gender, site of the stab wound, management, and complications were analyzed.
  
  
  RESULTS
  Twenty-six patients with hemodynamic instability at presentation underwent urgent laparotomy (LAP); 24 (92.3 %) of those procedures were therapeutic. Local wound exploration (LWE) proved that 114 (31 %) of all hemodynamically stable patients had no abdominal fascia penetration and consequently could be discharged home from the emergency department (ED). A total of 253 patients were found to have fascial penetration, and all were admitted for repeat clinical assessments (RCA) and imaging studies. A total of 121 (48 %) of the patients underwent abdominal exploration with 102 (84 %) therapeutic LAP procedures.
  
  
  CONCLUSIONS
  Hemodynamic instability and evisceration should continue to prompt urgent LAP. For stable patients, a sequence of LWE followed by focused abdominal sonography for trauma and computed tomography scanning for unclear cases primed by RCA was found to be efficient in limiting hospital admissions and reducing the rate of non-therapeutic LAP.
authors: Department of General Surgery, Faculty of Medicine Jordan University of Science and Technology (JUST), P.O. Box 3030, Irbid, Jordan. akomari@just.edu.jo
authors: Abdelkarim
authors: A
authors: Omari
authors: Mohammad
authors: M
authors: Bani-Yaseen
authors: Mohammad
authors: M
authors: Khammash
authors: Ghazi
authors: G
authors: Qasaimeh
authors: Fahmi
authors: F
authors: Eqab
authors: Hashem
authors: H
authors: Jaddou
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002648:Child; D003661:Decision Support Techniques; D003906:Developing Countries; D004636:Emergency Service, Hospital; D005260:Female; D006769:Hospitals, General; D006784:Hospitals, Teaching; D006801:Humans; D007597:Jordan / Q000453:epidemiology; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019564:Unnecessary Procedures; D014951:Wounds, Stab / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D055815:Young Adult
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