This paper is only available as a PDF. To read, Please Download here.
Abstract
Wounds of the back and flank pose a risk of injury to retroperitoneal structures which
may be missed on physical examination. Recently, a selective approach to these wounds
has been advocated. In order to document the incidence, management, and outcome of
patients with penetrating wounds of the back and flank, we undertook a retrospective
review of patients admitted over the past 5 years. Twenty-nine patients with penetrating
posterior abdominal wounds were reviewed. There were 17 stab wounds and 12 gunshot
wounds. All six patients who exhibited haemodynamic instability or abnormalities on
physical examination underwent emergency laparotomy. The remaining 23 patients were
admitted for observation. All patients underwent physical examination, abdominal radiographs,
and urinalysis. Nine underwent IVP. Eight patients had abdominal CTs. No peritoneal
lavages were performed. There were no missed injuries, no deaths and no delayed operations.
There were two complications in the operative group, and one liver abscess in the
nonoperative group. We conclude that selective management is a safe approach in penetrating
posterior abdominal trauma without obvious indications for laparotomy.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Management of penetrating wounds of the back and flank.Surg. Gynecol. Obstet. 1984; 159: 514
- Indications for operation in abdominal stab wounds: a prospective study of 651 patients.Ann. Surg. 1987; 205: 129
- A prospective, randomized comparison of computed tomography with conventional diagnostic methods in the evaluation of penetrating injuries to the back and flank.Arch. Surg. 1991; 126: 1115
- Triple contrast CT in the evaluation of posterior abdominal trauma.Arch. Surg. 1987; 122: 1112
- Management of stab wounds of the back and flank.J. Trauma. 1979; 19: 660
- Should laparotomy be mandatory or selective in gunshot wounds of the abdomen?.J Trauma. 1977; 17: 903
- Surgical judgement in the management of penetrating wounds of the abdomen: experience with 2,212 patients.Ann. Surg. 1974; 179: 639
- Posterior abdominal stab wounds.J. Trauma. 1981; 21: 298
- Use of contrast-enhanced CT enema in the management of penetrating trauma to the flank and back.J. Trauma. 1986; 26: 593
- The role of CT scan in evaluation for laparotomy in patients with stab wounds of the abdomen.J. Trauma. 1989; 29: 446
- Indications for operation in abdominal trauma.Am. J. Surg. 1960; 99: 657
- Blunt and penetrating diaphragmatic injuries with or without herniation of organs into the chest.Ann. Thorac. Surg. 1986; 42: 158
- Evaluation of peritoneal lavage and local exploration in lower chest and abdominal stab wounds.J. Trauma. 1977; 17: 642
- The evolution of abdominal stab wound management.J. Trauma. 1980; 20: 478
Article info
Publication history
Accepted:
April 6,
1994
Identification
Copyright
© 1994 Published by Elsevier Inc.
