MANAGEMENT OF PENETRATING ABDOMINAL-TRAUM A

In general, laparotomy is accepted as treatment of choice for abdomina l shot wounds. However, the management of abdominal stab wends is cont roversial. In order to study the concept of laparotomy for penetrating abdominal trauma our patient collective was analyzed retrospectively. From Ist January 1985 to 31st December 1993 we performed laparotomy i n 30 cases of abdominal stab wounds. 24 patients were victims of viole nce. In 6 patients the cause of injury was a suicidal attempt. Laparot omy was negative in 27% of cases. In most cases explorative laparotomy showed injuries of the vessels (n = 12) and the intestines (n = 9). T he mortality rate was 6.7%. None of the fatal cases was caused by nega tive laparotomy. During a mean follow-up time of 54 months none of the patients showed disorders of late onset after negative laparotomy. Be cause of the limited diagnostic possibilities to rule out intestine in jury and minimal morbidity of negative laparotomies we continue fo fac our laparotomy in the management of penetrating abdominal trauma.