Factors that Predict the Need of Abdominal Exploration in Penetrating Anterior and Thoraco Abdominal Stab Wounds: Retrospective Analysis
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- Category: Vol. 84, December 2016
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Factors that Predict the Need of Abdominal Exploration in Penetrating Anterior and Thoraco Abdominal Stab Wounds: Retrospective Analysis, NADER M. MILAD, DOAA A. MANSOUR, KARIM K. MAURICE, HANY M.S. MIKHAIL and MOHAMED SABER
Abstract
Background: Several algorithms have been formulated regarding the management of penetrating anterior and thoraco-abdominal stab wounds. The goal of each is to triage the patients into a conservative versus a surgical management relying on several factors including clinical assessment and diagnostic modalities. Hence, it has been important to recog-nize the value of each in the decision making regarding the management of these injuries.
Aim of the Study: This study was conducted to compare the results of the preoperative investigations (White cell count, Focused assessment with sonography for trauma FAST) and physical signs (Abdominal rigidity and omental evisceration) to the operative outcomes in patients with anterior and thoraco-abdominal stab wounds.
Patients: This retrospective study included 50 patients who presented to Kasr Al-Ainy Emergency Department with anterior and thoraco-abdominal stab wounds during the period from March 2014 to June 2015.
Methods: The operative data were collected and the findings were compared to the preoperative investigations done (White cell count, FAST) and the physical signs preop-eratively (Abdominal rigidity and omental evisceration) to determine the sensitivity, specificity and predictive values of each.
Results: Based on the statistical analysis, it was found that the presence of omental evisceration or abdominal rigidity were strong predictors for a therapeutic operation. However, the presence of a high white cell count or a positive FAST (Focused Assessment with Sonography for Trauma) had a low sensitivity and specificity regarding the need of a laparo-tomy, thus they should be used in conjunction to other modal-ities to guide the decision of the surgeon.