title: Efficacy of computed tomography for abdominal stab wounds: a single institutional analysis.
abstract: OBJECTIVE
  There are several diagnostic tools to support the decision for abdominal stab wounds. The aim of this study is to evaluate the ability of computed tomography (CT) to facilitate decisions on the initial management in patients with anterior abdominal stab wounds.
  
  
  METHODS
  The medical records of all 118 patients who sustained abdominal stab wounds from March 2004 to January 2012 were reviewed retrospectively.
  
  
  RESULTS
  The average age of patients was 41 years, and 84 (71%) patients were male. Ten patients underwent an immediate laparotomy due to hemodynamic instability, peritonitis, or definite evisceration. The other 108 patients underwent CT scans, and 91 patients had positive CT findings, leading to performance of laparotomy in 82 patients. One patient underwent a non-therapeutic laparotomy. Seventeen patients had negative CT results; however, seven patients underwent early laparotomy according to the attending surgeon's decision using serial physical examination or other diagnostic tools. The sensitivity of the CT scan was 94.2%, and the positive-predictive value was 98.8%.
  
  
  CONCLUSIONS
  CT can be used efficiently along with physical examination as an initial diagnostic tool in patients with abdominal stab wounds. However, there can be missed injuries, then surgeon should consider other diagnostic methods.
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, South Korea.
authors.forename: G J
authors.initials: GJ
authors.lastname: Lee
authors.forename: G
authors.initials: G
authors.lastname: Son
authors.forename: B C
authors.initials: BC
authors.lastname: Yu
authors.forename: J N
authors.initials: JN
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Chung
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007813:Laparotomy / Q000379:methods; D008297:Male; D010808:Physical Examination / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014951:Wounds, Stab / Q000000981:diagnostic imaging* / Q000601:surgery