Rezende-Neto João Baptista, Vieira Hélio Machado, Rodrigues Bruno de Lima, Rizoli Sandro, Nascimento Barto, Fraga Gustavo Pereira
University of Toronto, Toronto, Canada.
Albert Sabin Israeli Hospital, Rio de Janeiro, RJ, Brazil.
Rev Col Bras Cir. 2014 Jan-Feb;41(1):75-9. doi: 10.1590/s0100-69912014000100015.
The meeting of the Publication "Evidence Based Telemedicine - Trauma and Emergency Surgery" (TBE-CiTE), through literature review, selected three recent articles on the treatment of victims stab wounds to the abdominal wall. The first study looked at the role of computed tomography (CT) in the treatment of patients with stab wounds to the abdominal wall. The second examined the use of laparoscopy over serial physical examinations to evaluate patients in need of laparotomy. The third did a review of surgical exploration of the abdominal wound, use of diagnostic peritoneal lavage and CT for the early identification of significant lesions and the best time for intervention. There was consensus to laparotomy in the presence of hemodynamic instability or signs of peritonitis, or evisceration. The wound should be explored under local anesthesia and if there is no injury to the aponeurosis the patient can be discharged. In the presence of penetration into the abdominal cavity, serial abdominal examinations are safe without CT. Laparoscopy is well indicated when there is doubt about any intracavitary lesion, in centers experienced in this method.
