Abdominal stab wounds: evaluation of sinography.

This paper reviews a 30-month experience with 172 patients suffering abdominal stab wounds treated at the Denver General Hospital, during a period when policy included liberal sinography and all penetrating injuries were explored. Laparotomy was performed in 87%. Of the 65 patients undergoing sinography, 62% indicated peritoneal penetration; of these, 30% had no visceral injury. An additional 10%, with minor intraperitoneal injuries, probably would not have required celiotomy. In 25 cases the stab penetrated the peritoneal cavity after first entering the chest. Peritoneal tap and peritoneal lavage were used in 10 patients. It is concluded that the cost/benefit ratio of sinography is so poor that it is rarely indicated. When doubt exists as to significant intraperitoneal pathology following an abdominal stab wound, close observation without sinography is recommended for determining indication for laparotomy.