Penetran karın travmalarında konservatif yaklaşım

  • Cahfer Güloğlu
  • Mustafa Aldemir
  • Yusuf Yağmur

Eurasian J Emerg Med 2004;3(3):19-22

Conservative treatment of penetrating abdominal injuries would avoid non-therapeutic laparotomy and decrease hospitalization time in selected patients. The aim of this study was to evaluate pattern of injury, demographic and laboratory values in patients with penetrating abdominal injuries treated with laparotomy surgically or conservatively with strict observation. 87 patients (81 male, 6 female) with penetrating abdominal injuries applied to Dicle University Emergency Service in 2000 were included in this study. After examination and serious evaluation, in 56 patients injuries were penetrating the abdomen while in 31 were not penetrating. Among 56 patients, 36 were treated surgically, 20 were treated conservatively. Conservatively treated patients were observed for 24 hours. Among 36 surgically treated patients, 19 had hypotension, 16 had tachycardia, and 10 had anemia. In conservatively treated group, 5 patients were hypotensive, 5 had tachycardia and one was anemic. 14 of 36 surgical patients also had thoracic procedures while 5 of 20 conservative patients had thoracic procedures. 26 of 56 patients undergone laparotomy. The most commonly injured organs were liver and spleen (11 patients). Laparotomy was negative in 6 patients. The mean length of stay for surgically treated patients was 8 days. As a conclusion, conservative treatment in selected patients with penetrating abdominal injury would decrease non-therapeutic laparotomy rate, morbidity related to surgery, length of hospital stay and cost of treatment.

Keywords: Stab wounds, abdominal injury, penetration, laparotomy, Nonoperative Management