The management of penetrating abdominal stab wounds with organ or omentum evisceration: The results of a clinical trial.
OBJECTIVE
The therapeutic approach to abdominal penetrating stab injuries has changed over the years from routine laparotomy to non-operative treatment. In case of organ or omental evisceration, although the laparotomy need is greater, non-operative treatment may be applied in selected cases. The aim of our study was to assess the follow-up and treatment outcomes of patients with organ or omental evisceration due to penetrating abdominal injuries.


METHODS
Patients with organ or omental evisceration due to penetrating abdominal stab injuries were prospectively evaluated between April 2009 and July 2012. Emergent laparotomy was performed in cases that were hemodynamically unstable or had signs of organ evisceration or peritonitis, while other patients were managed conservatively. Patients' follow-up and treatment outcomes were assessed.


RESULTS
A total of 18 patients with organ or omental evisceration were assessed. Six (33.3%) patients underwent emergent laparotomy, and 12 (66.7%) patients underwent conservative follow-up. Three patients in the emergent laparotomy group had signs of organ evisceration, and 3 had signs of peritonitis; five of these 6 patients underwent therapeutic laparotomy and 1 negative laparotomy. In the non-operative follow-up group, therapeutic laparotomy was carried out in a total of 7 patients, 4 being early and 3 late, due to development of peritonitis, whereas 5 (27.8%) patients were managed non-operatively.


CONCLUSIONS
Although organ or omental eviscerations due to penetrating abdominal stab injuries have a high rate of therapeutic laparotomy, selective conservative therapy is a safe method in selected cases.
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Metin
M
Yücel
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Adnan
A
Özpek
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Sema
S
Yüksekdağ
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
İsmail
İ
Kabak
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Fatih
F
Başak
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Ali
A
Kılıç
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Gürhan
G
Baş
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Orhan
O
Alimoğlu
Organ evisceration; emergent surgery; non-operative management; omentum evisceration