Kong Victor Y, Weale Ross, Blodgett Joanna M, Buitendag Johan, Bruce John L, Laing Grant L, Clarke Damian L
Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa; Department of Surgery, University of KwaZulu-Natal, Durban, South Africa.
Department of Surgery, Wessex Deanery, Wessex, United Kingdom.
Injury. 2019 Jan;50(1):156-159. doi: 10.1016/j.injury.2018.08.003. Epub 2018 Aug 7.
Organ evisceration following abdominal stab wound (SW) is currently considered as an absolute indication for mandatory laparotomy due to the high incidence of associated intra-abdominal injuries, but literature describing the spectrum of organ injury encountered is limited.
We reviewed our experience of 301 consecutive patients who were subjected to mandatory laparotomy over an eight-year period at a major trauma centre in South Africa.
Of the 301 patients with organ evisceration, 92% were male (mean age: 28 years). Ninety per cent (270/301) of the laparotomies were positive (85% (229/270) therapeutic, 15% (41/270) non-therapeutic). The frequencies of eviscerated organs were small bowel (70%), large bowel (26%), and stomach 3%. Three (1%) patients had combined evisceration of more than one of the above organs. The most commonly injured organs were small bowel and large bowel. The mean length of hospital stay was nine days. Seven patients required intensive care admission. The morbidity rate was 21% and mortality was 2%.
The spectrum of injury associated with abdominal SW with organ evisceration is similar to smaller published series. Multiple organ injuries are common. The most commonly eviscerated organs were small bowel, large bowel and stomach, while the most commonly injured organs were small bowel and large bowel.
腹部刺伤（SW）后脏器脱出目前被视为必须进行剖腹手术的绝对指征，因为其合并腹内损伤的发生率很高，但描述所遇到的脏器损伤范围的文献有限。
我们回顾了在南非一家主要创伤中心八年间连续接受剖腹手术的301例患者的经验。
在301例脏器脱出患者中，92%为男性（平均年龄：28岁）。90%（270/301）的剖腹手术结果为阳性（85%（229/270）为治疗性，15%（41/270）为非治疗性）。脱出脏器的频率为小肠（70%）、大肠（26%）和胃（3%）。3例（1%）患者有上述多个器官联合脱出。最常受伤的器官是小肠和大肠。平均住院时间为9天。7例患者需要入住重症监护病房。发病率为21%，死亡率为2%。
与腹部刺伤伴脏器脱出相关的损伤范围与已发表的较小系列研究相似。多器官损伤很常见。最常脱出的器官是小肠、大肠和胃，而最常受伤的器官是小肠和大肠。
