Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa; Department of Surgery, University of KwaZulu Natal, Durban, South Africa.
Department of Surgery, University of KwaZulu Natal, Durban, South Africa; Department of Surgery, North West Deanery, Manchester, United Kingdom.
Am J Surg. 2019 Apr;217(4):653-657. doi: 10.1016/j.amjsurg.2018.06.003. Epub 2018 Jun 15.
The spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature in the specific setting of isolated omental evisceration is limited.
We reviewed our experience of 244 consecutive patients with established indications for laparotomy over an eight year period at a major trauma centre in South Africa.
Of the 244 patients (93% male, mean age: 27 years), 224 (92) underwent immediate laparotomy (IL). Twenty were initially observed and eventually required a laparotomy (delayed laparotomy, DL). The mean time from injury to decision for laparotomy was <3 h in 92% (224/244), <6 h in 6% (14/244), <12 h 2% (4/244) and <18 h in 1% (2/244). Ninety-eight per cent (238/244) of laparotomies were positive and 96% of the positive laparotomies (229/238) were considered therapeutic. The mostly commonly injured organ encountered on laparotomy were small bowel, stomach and colon.
The most commonly injures encountered are intestinal and gastric. Clinicians must remain vigilant as injuries may be subtle.
前腹部刺伤(SW)相关损伤的范围已经明确。孤立性大网膜脱出的具体文献有限。
我们回顾了南非一家主要创伤中心在 8 年期间对 244 例有明确剖腹术指征的患者的经验。
244 例患者中(93%为男性,平均年龄:27 岁),224 例(92%)立即行剖腹术(IL)。20 例最初接受观察,最终需要剖腹术(延迟剖腹术,DL)。92%(224/244)的患者从受伤到决定剖腹术的时间<3 小时,6%(14/244)的患者<6 小时,2%(4/244)的患者<12 小时,1%(2/244)的患者<18 小时。98%(238/244)的剖腹术为阳性,238 例阳性剖腹术中的 96%(229/238)被认为是治疗性的。剖腹术中最常遇到的损伤器官是小肠、胃和结肠。
最常遇到的损伤是肠和胃。临床医生必须保持警惕,因为损伤可能是微妙的。