title: The predictive value of physical examination in the decision of laparotomy in penetrating anterior abdominal stab injury.
abstract: A selective conservative treatment for penetrating anterior abdominal stab injuries is an increasingly recognized approach. We analyzed patients who followed-up and treated for penetrating anterior abdominal stab injuries. The anterior region was defined as the area between the arcus costa at the top and the mid-axillary lines at the laterals and the inguinal ligaments and symphysis pubis at the bottom. An emergency laparotomy was performed on patients who were hemodynamically unstable or had symptoms of peritonitis or organ evisceration; the remaining patients were followed-up selectively and conservatively. A total of 175 patients with purely anterior abdominal injuries were included in the study. One hundred and sixty-five of the patients (94.29%) were males and 10 (5.71%) were females; the mean age of the cohort was 30.85 years (range: 14-69 years). While 16 patients (9%) were made an emergency laparotomy due to hemodynamic instability, peritonitis or evisceration, the remaining patients were hospitalized for observation. During the selective conservative follow-up, an early laparotomy was performed in 20 patients (12%), and a late laparotomy was performed in 13 patients (7%); the remaining 126 patients (72%) were discharged after non-operative follow-up. A laparotomy was performed on 49 patients (28%); the laparotomy was therapeutic for 42 patients (86%), non-therapeutic for 4 patients (8%), and negative for 3 patients (6%). A selective conservative approach based on physical examination and clinical follow-up in penetrating anterior abdominal stab injuries is an effective treatment approach.
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Yucel
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Gurhan
authors.initials: G
authors.lastname: Bas
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Ozpek
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Basak
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Sisik
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Acar
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Buket Altun
authors.initials: BA
authors.lastname: Ozdemir
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Yuksekdag
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Alimoglu
keywords: Anterior abdominal penetrating stab injuries; emergency laparotomy; non-operative treatment; physical examination