Penetrating abdominal wounds. Rationale for exploratory laparotomy. 1985

E E Moore, and J A Marx

Over the past decade a general consensus has evolved about the indications for celiotomy after civilian penetrating wounds. Stab injuries to the anterior part of the abdomen clearly warrant a selective approach based on physical signs, local wound exploration, and diagnostic peritoneal lavage. Gunshot wounds violating the peritoneum, on the other hand, mandate abdominal exploration. Peritoneal lavage is also valuable for the selective management of lower thoracic penetrating wounds. Back and flank injuries are difficult to assess, and patient care must be individualized with the assistance of retroperitoneal contrast studies. Although the adjunctive role of peritoneal lavage in the evaluation of penetrating wounds has substantially reduced unnecessary celiotomy, the safest policy is to explore the abdomen if any question of visceral injury exists.

UI MeSH Term Description Entries
D007813 Laparotomy Incision into the side of the abdomen between the ribs and pelvis. Minilaparotomy,Laparotomies,Minilaparotomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000007 Abdominal Injuries General or unspecified injuries involving organs in the abdominal cavity. Injuries, Abdominal,Abdominal Injury,Injury, Abdominal
D001415 Back The rear surface of an upright primate from the shoulders to the hip, or the dorsal surface of tetrapods.
D013909 Thorax The upper part of the trunk between the NECK and the ABDOMEN. It contains the chief organs of the circulatory and respiratory systems. (From Stedman, 25th ed) Chest,Thoraces,Chests,Thorace
D014948 Wounds, Gunshot Disruption of structural continuity of the body as a result of the discharge of firearms. Gunshot Wound,Gunshot Wounds,Wound, Gunshot
D014950 Wounds, Penetrating Wounds caused by objects penetrating the skin. Penetrating Wound,Penetrating Wounds,Wound, Penetrating
D014951 Wounds, Stab Penetrating wounds caused by a pointed object. Stab Wound,Stab Wounds,Wound, Stab
D049672 History, 19th Century Time period from 1801 through 1900 of the common era. 19th Century History,19th Cent. History (Medicine),19th Cent. History of Medicine,19th Cent. Medicine,Historical Events, 19th Century,History of Medicine, 19th Cent.,History, Nineteenth Century,Medical History, 19th Cent.,Medicine, 19th Cent.,19th Cent. Histories (Medicine),19th Century Histories,Cent. Histories, 19th (Medicine),Cent. History, 19th (Medicine),Century Histories, 19th,Century Histories, Nineteenth,Century History, 19th,Century History, Nineteenth,Histories, 19th Cent. (Medicine),Histories, 19th Century,Histories, Nineteenth Century,History, 19th Cent. (Medicine),Nineteenth Century Histories,Nineteenth Century History
D049673 History, 20th Century Time period from 1901 through 2000 of the common era. 20th Century History,20th Cent. History (Medicine),20th Cent. History of Medicine,20th Cent. Medicine,Historical Events, 20th Century,History of Medicine, 20th Cent.,History, Twentieth Century,Medical History, 20th Cent.,Medicine, 20th Cent.,20th Cent. Histories (Medicine),20th Century Histories,Cent. Histories, 20th (Medicine),Cent. History, 20th (Medicine),Century Histories, 20th,Century Histories, Twentieth,Century History, 20th,Century History, Twentieth,Histories, 20th Cent. (Medicine),Histories, 20th Century,Histories, Twentieth Century,History, 20th Cent. (Medicine),Twentieth Century Histories,Twentieth Century History

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