A Clinical Analysis of Abdominal Stab Injuries for Five Years

Ko,  Young Gil; Kim,  Bang Joo; Baek,  Kwang Je; Cho,  Young Up; Kim,  Jun Sig

J Korean Soc Emerg Med > Volume 14(5); 2003 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2003;14(5): 536-543.

A Clinical Analysis of Abdominal Stab Injuries for Five Years

Young Gil Ko, Bang Joo Kim, Kwang Je Baek, Young Up Cho, Jun Sig Kim

¹Department of Emergency Medicine, College of Medicine, Inha University, Incheon, Korea. jskimmd@inha.ac.kr
²Department of General Surgery, College of Medicine, Inha University, Incheon, Korea.

ABSTRACT

PURPOSE:
The prognosis of a patient in the management of abdominal stab wound depends on the time of emergency exploration and on how much negative exploration rates can be decreased. We will examine the indication and the treatment plan of emergency exploration by the clinical evaluation of the patients in this hospital.
METHODS:
Charts of all patients with abdominal stab wound were reviewed that they admitted at the emergency room for 5 years between January 1st, 1998 and December 31th, 2002 and the indication of an emergency abdominal exploration was analysed on four-category bases.
RESULTS:
1) In 39 cases of Group which emergency exploration, negative exploration rate was 30.8%. 2) Operated patients were not observed intraabdominal organ injury in 1 of 13 cases (7.7%) which were hemodynamic unstable, 3 of 28 (10.7%) which were peritoneal irritation sign, 3 of 9 (33.3%) which were evisceration of bowel or omentum, 2 of 15 (13.3%) which were organ injury or hemoperitoneum on abdominal CT finding basis. 3) The complication and mortality rate in our study was 11.6%, 2.3%.
CONCLUSION:
There is no doubt about the operation of emergency abdominal exploration for hemodynamic instability or generalized peritonitis. But the evisceration of bowel or omentum, by itself, should not be judged to be an indication. And it is considered that in the case of hemodynamic stable patient, to decrease negative exploration rates, the decision of an abdominal exploration by an abdominal CT finding is valuable enough if it has a clear basis.

Key words: Indication, Exploration, Emergency, Abdomen