[Preoperative leukocytosis as a predictor of intrabdominal injury in penetrating abdominal trauma].

BACKGROUND

in Mexico, the management of abdominal penetrating trauma doesn't follow the algorithms of Trauma Center level I, because of our limitations, and laparotomies are inevitable in this context. Is possible use some grade of leukocytosis suspect in-trabdominal lesion?

METHODS

study retrospective, descriptive and analytic that inclu-ded patients with abdominal penetrating trauma that suffered exploratory laparotomy. We excluded patients' whit severe damage to soft tissues in extremities, thoracic affection, fractures, or da-mage in nervous system. We divided the patients into 2 groups: group I (therapeutic laparotomy) and group II (non-therapeutic laparotomy). Dependent variables were; age, gender, type of injury, number of lesions, peripheral lesions, time between injury and, from a laboaratory blood sample, leukocytosis mean, percentage of neutrophils, leukocytosis ≥ 12,500 /mm(3), and hemoperitoneum. We compared variables between two groups and use Pearson's χ(2) test and T-Student, and percentages as summary of measures.

RESULTS

we included 231 patients, group I with 159 patients and group II with 72 patients. Leukocytosis global was 13.2 mil/mm(3) and neutrophil range of 70.3%. 26% of patients did not have leukocytosis at arrival and evaluation, however they were laparotomized because of present peritoneal irritation. Leukocytosis ≥ 12.5 mil/mm(3) was statistically significant in patients with intrabdominal lesions (74.2% vs 27.7%, p < 0.001).

CONCLUSIONS

leukocytosis ≥ 12.5 mil/mm(3) could be an early serum marker abdominal penetrating trauma.