Selective conservatism in the management of penetrating abdominal bull-gore injuries. 1993

F Christian, and R L Robinson
CSI Mission Hospital, Chickballapur, Karnataka State, India.

In a retrospective analysis it was found that not all patients with penetrating bull-gore injuries of the abdomen need exploration by formal laparotomy. A policy of selective conservatism was followed in the management of 18 out of 20 patients with bull-gore injuries of the abdomen in whom peritoneal breach was established either on presentation or by digital exploration of the wound. Formal laparotomy was reserved for specific clinical indications. Out of the 18 cases, 14 (78 per cent) were successfully treated non-operatively with wound excision, simple closure of the wound, and careful repeated clinical evaluation. There was no mortality in this group. Four cases (22 per cent) were explored; three of these had indications for exploration on presentation and the fourth was explored 4 days after admission. The latter was the only death that occurred in the series; the cause of death was probably pulmonary embolism. Omental and/or bowel evisceration occurred in 11 out of 18 cases (61 per cent). However, this was not considered an indication for exploration and all 11 cases were treated by simple replacement of omentum or bowel into the abdominal cavity. Penetrating abdominal bull-gore injuries can be managed safely by a policy of selective conservatism, reserving formal laparotomy for specific clinical indications.

UI MeSH Term Description Entries
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
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
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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