McFarlane M E
Department of Surgery, Kingston Public Hospital, Jamaica.
J R Coll Surg Edinb. 1996 Aug;41(4):239-40.
A consecutive series of 14 patients with anterior abdominal stab wounds and omental evisceration treated at the Kingston Public Hospital Jamaica over a 3-year period is presented. During this period 223 patients with abdominal stab wounds were seen of which 66 had omental evisceration. Conservative surgical management was the approach followed in 14 patients who presented without signs of peritonitis. There were no late complications or missed visceral injuries necessitating laparotomy. Serial physical examination was the method used to select patients for conservative surgical management with the exclusion of patients with deteriorating clinical signs or peritonitis. Omental evisceration through an abdominal stab wound in a patient with stable clinical signs and without evidence of peritonitis is not an absolute indication for exploratory laparotomy.
本文介绍了在牙买加金斯敦公立医院3年期间连续收治的14例腹部刺伤伴网膜脱出患者。在此期间,共诊治223例腹部刺伤患者,其中66例伴有网膜脱出。14例无腹膜炎体征的患者采用了保守手术治疗。没有出现需要剖腹手术的晚期并发症或漏诊的内脏损伤。连续体格检查是选择保守手术治疗患者的方法,排除临床体征恶化或有腹膜炎的患者。对于临床体征稳定且无腹膜炎证据的腹部刺伤伴网膜脱出患者,并非绝对需要进行剖腹探查术。