Siddharth B Raj, Keerthi M S S, Naidu Subrahmaneswara Babu, Venkanna M
Mahatma Gandhi Memorial Hospital, Kakatiya Medical College, Warangal, Telangana India.
Indian J Surg. 2017 Jun;79(3):196-200. doi: 10.1007/s12262-016-1459-0. Epub 2016 Feb 16.
Penetrating abdominal trauma forms an important component of surgical emergencies, most of the victims being young aged in the prime of their life. Over the past century, the diagnosis and management of this common problem has seen drastic changes, finally reaching the destination of . We present our experience in the management of this group of patients in the rural setup. This is a prospective observational study done at our hospital between 1 April 2013 and 31 March 2015 including patients who presented with penetrating abdominal injury. The clinical presentation, imaging features, diagnosis, management, and complications of all these patients are analyzed. The mean age was 33.5 years with majority being males. Homicidal stab injuries accounted for most of the injuries (62.5 %). Forty-eight patients underwent laparotomy, and among which, the procedure was therapeutic in 36 patients. Peritoneal penetration was the best predictor of a therapeutic laparotomy with a high sensitivity and positive predictive value (100 and 80 %, respectively). The small intestine was the most commonly injured organ. The mean postoperative stay was 8.25 days, and there was no mortality. Though the management of these patients should aim at minimizing the rate of negative laparotomies, this should not be done at the expense of delayed diagnosis and treatment. Diagnostic laparoscopy may avoid unnecessary laparotomies; however, it requires adequate skills in laparoendoscopy. Management is best tailor made for each individual based on the nature of injury, findings at presentation, and the organ injured.
穿透性腹部创伤是外科急症的重要组成部分,大多数受害者为正值青壮年的年轻人。在过去的一个世纪里,这个常见问题的诊断和处理发生了巨大变化,最终达到了……我们介绍我们在农村地区处理这类患者的经验。这是一项前瞻性观察性研究,于2013年4月1日至2015年3月31日在我院进行,纳入了穿透性腹部损伤患者。对所有这些患者的临床表现、影像学特征、诊断、处理及并发症进行分析。平均年龄为33.5岁,大多数为男性。凶杀刺伤占大多数损伤(62.5%)。48例患者接受了剖腹手术,其中36例手术具有治疗意义。腹膜穿透是治疗性剖腹手术的最佳预测指标,具有高敏感性和阳性预测值(分别为100%和80%)。小肠是最常受伤的器官。术后平均住院时间为8.25天,无死亡病例。尽管对这些患者的处理应以尽量减少阴性剖腹手术率为目标,但不应以延迟诊断和治疗为代价。诊断性腹腔镜检查可避免不必要的剖腹手术;然而,这需要足够的腹腔镜内镜技术。应根据损伤的性质、就诊时的发现及受伤器官为每个患者量身定制最佳处理方案。