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

  • Patrizia MalkomesEmail author
  • Philipp Störmann
  • Hanan El Youzouri
  • Sebastian Wutzler
  • Ingo Marzi
  • Thomas Vogl
  • Wolf Otto Bechstein
  • Nils Habbe
Original Article

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.

Keywords

Penetrating abdominal trauma Stab and gunshot wounds Management algorithm SNOM 

Notes

Compliance with ethical standards

Conflict of interest

Patrizia Malkomes, Philipp Störmann, Hanan El Youzouri, Sebastian Wutzler, Ingo Marzi, Thomas Vogl, Wolf Otto Bechstein and Nils Habbe declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Human rights and animal participants

This article does not contain any studies with animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General and Visceral SurgeryUniversity Hospital FrankfurtFrankfurtGermany
  2. 2.Department of Trauma-, Hand- and Reconstructive SurgeryUniversity Hospital FrankfurtFrankfurtGermany
  3. 3.Institute for Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurtGermany
  4. 4.Department of Surgery and ColoproctologyDKD Helios KlinikWiesbadenGermany

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