title: [Management of penetrating abdominal trauma: what we need to know?].
abstract: Penetrating traumas are rare in France and mainly due to stabbing. Knives are less lethal than firearms. The initial clinical assessment is the cornerstone of hospital care. It remains a priority and can quickly lead to a surgical treatment first. Urgent surgical indications are hemorrhagic shock, evisceration and peritonitis. Dying patients should be immediately taken to the operating room for rescue laparotomy or thoracotomy. Ultrasonography and chest radiography are performed before damage control surgery for hemodynamic unstable critical patients. Stable patients are scanned by CT and in some cases may benefit from non-operative strategy. Mortality remains high, initially due to bleeding complications and secondarily to infectious complications. Early and appropriate surgery can reduce morbidity and mortality. Non-operative strategy is only possible in selected patients in trained trauma centers and with intensive supervision by experienced staff.
authors: Département d'anesthésie-réanimation, hôpital d'instruction des armées Percy, BP 406, 101, avenue Henri-Barbusse, 92141 Clamart cedex, France. clement.hoffmann@yahoo.fr
authors: C
authors: C
authors: Hoffmann
authors: Y
authors: Y
authors: Goudard
authors: E
authors: E
authors: Falzone
authors: T
authors: T
authors: Leclerc
authors: M
authors: M
authors: Planchet
authors: N
authors: N
authors: Cazes
authors: F
authors: F
authors: Pons
authors: B
authors: B
authors: Lenoir
authors: B
authors: B
authors: Debien
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D000758:Anesthesia; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D004632:Emergency Medical Services; D005602:France / Q000453:epidemiology; D006801:Humans; D010346:Patient Care Management; D014057:Tomography, X-Ray Computed; D014148:Tranexamic Acid / Q000627:therapeutic use; D014950:Wounds, Penetrating / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D014951:Wounds, Stab / Q000628:therapy
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid