Intrathoracic Abdominal Stab Wounds: Indication for Exploratory Laparotomy
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Abstract
Background: Obvious peritoneal signs, shock and evisceration were accepted as the indication for early laparotomy of intrathoracic abdominal stab wounds. Victims who did not present the above symptoms and signs, laparoscopy or DPL were advised to make indication for abdominal operation. Objective: To find out the incidence and indication for laparotomy of intrathoracic abdominal stab wounds (lower chest). Patients & Methods: Retrospective reviewed of patients who were operated from the cause of abdominal stab wounds during January 1, 1997 to December 31, 2006. Results: Two hundred and eighty seven patients were identified. Fifty nine of them (20.6%) sustained stab wounds of lower chest. Forty patients (67.8%) had indications for early laparotomy. Positive DPL found in ten patients (16.9%). Positive wound exploration in four patients (6.8%) sustained both lower chest and anterior abdominal stab wounds and other indications in five (8.5%). There were thirty seven patients (92.5%) of early laparotomy group had significant intraabdominal organ injuries. While 100% and 25% significant injuries found in DPL and wound exploration consecutively. The nineteen complications occurred in thirteen patients (22.0%), no death was noted. Conclusion: In this study it is concluded that indications for early laparotomy of intrathoracic abdominal stab wounds are clear. In cases of non-early-operated patients DPL is an appropriated diagnostic modality especially, in the rural hospital.
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