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

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 inju...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 45; no. 2; pp. 315 - 322
Autores principales: Malkomes, Patrizia, El Youzouri, Hanan, Bechstein, Wolf Otto, Störmann, Philipp, Wutzler, Sebastian, Marzi, Ingo, Vogl, Thomas, Habbe, Nils
Formato: algorithm research tables/charts Journal Article
Publicado: Springer Nature Apr2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2019
      vid: 45
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-018-0911-1
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        atl: Characteristics and management of penetrating abdominal injuries in a German level I trauma center.
      aug:
        au:
          Malkomes, Patrizia
          El Youzouri, Hanan
          Bechstein, Wolf Otto
          Störmann, Philipp
          Wutzler, Sebastian
          Marzi, Ingo
          Vogl, Thomas
          Habbe, Nils
        affil: Department of General and Visceral Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
      sug:
        subj:
          Wounds, Penetrating Therapy
          Abdominal Injuries Therapy
          Wound Care Germany
          Human
          Retrospective Design
          Record Review
          Wounds, Stab
          Wounds, Gunshot
          Germany
          Ultrasonography
          Tomography, X-Ray Computed
          Descriptive Statistics
          Laparoscopy
      ab: 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.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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