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European Journal of Trauma and Emergency Surgery

Published in:

01-04-2019 | Original Article

Characteristics and management of penetrating abdominal injuries in a German level I trauma center

Authors: Patrizia Malkomes, Philipp Störmann, Hanan El Youzouri, Sebastian Wutzler, Ingo Marzi, Thomas Vogl, Wolf Otto Bechstein, Nils Habbe

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2019

Abstract

Purpose

Penetrating abdominal injuries caused by stabbing or firearms are rare in Germany, thus there is lack of descriptive studies. The management of hemodynamically stable patients is still under dispute. The aim of this study is to review and improve our management of penetrating abdominal injuries.

Methods

We retrospectively reviewed a 10-year period from the Trauma Registry of our level I trauma center. The data of all patients regarding demographics, clinical and outcome parameters were examined. Further, charts were reviewed for FAST and CT results and correlated with intraoperative findings.

Results

A total of 115 patients with penetrating abdominal trauma (87.8% men) were analyzed. In 69 patients, the injuries were caused by interpersonal violence and included 88 stab and 4 firearm wounds. 8 patients (6.9%) were in a state of shock at presentation. 52 patients (44.8%) suffered additional extraabdominal injuries. 38 patients were managed non-operatively, while almost two-thirds of all patients underwent surgical treatment. Hereof, 20 laparoscopies and 3 laparotomies were nontherapeutic. There were two missed injuries, but no patient experienced morbidity or mortality related to delay in treatment. 106 (92.2%) FAST and 91 (79.3%) CT scans were performed. Sensitivity and specificity of FAST were 59.4 and 94.2%, while those of CT were 93.2 and 85.1%, respectively.

Conclusion

In hemodynamically stable patients presenting with penetrating abdominal trauma, CT is indicated and the majority of injuries can be managed conservatively. If surgical treatment is required, diagnostic laparoscopy for stable patients is feasible to avoid nontherapeutic laparotomy.

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Title: Characteristics and management of penetrating abdominal injuries in a German level I trauma center
Authors: Patrizia Malkomes
Philipp Störmann
Hanan El Youzouri
Sebastian Wutzler
Ingo Marzi
Thomas Vogl
Wolf Otto Bechstein
Nils Habbe
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-0911-1

At a glance: The STEP trials

Springer Medicine

Characteristics and management of penetrating abdominal injuries in a German level I trauma center

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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