Changing Trends in the Management of Penetrating Abdominal Trauma - from Mandatory Laparotomy towards Conservative Management.
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Date
2016-11
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Abstract
Background: Penetrating abdominal trauma is a commonly encountered emergency surgical condition. Though it is less
common compared to blunt abdominal trauma, it is more dramatic due to the nature of the causative modes of injury
involved. Mandatory laparotomy, which was earlier advocated for these cases, has gradually been replaced by
conservative management in carefully selected cases thereby avoiding the unnecessary complications associated with
laparotomy. Aims and objectives: To study the efficacy of conservative management in cases of penetrating abdominal
trauma thereby obviating the need for unnecessary laparotomy. Methods: It was a prospective study conducted in a
tertiary hospital, involving 64 patients, over a 2 year period. All patients underwent a CT scan to identify their injuries
following a clinical examination and patients were managed conservatively or underwent laparotomy based on the CT
findings.Results: Of the 64 patients 53 were managed conservatively making it a success rate of 82.81%. Only 2 patients
who had a negative CT scan needed a subsequent laparotomy making it a very reliable investigation in these patients.
Conclusion: Conservative management for penetrating abdominal trauma patients is effective in the majority of cases and
hence can be advocated in the initial management plan of these cases supplemented by serial assessment of physical
symptoms and signs, unless laparotomy is considered necessary based on their initial CT or physical examination findings.
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Penetrating abdominal trauma, mandatory laparotomy, conservative management, CT scan
Citation
Shashikala C K, Gautham M V, Kagwad Suraj. Changing Trends in the Management of Penetrating Abdominal Trauma - from Mandatory Laparotomy towards Conservative Management. Annals of International Medical and Dental Research. 2016 Nov-Dec; 2(6): 19-23.