Kong VY, Weale R, Blodgett JM, Buitendag J, Oosthuizen GV, Bruce JL, Laing GL, Clarke DL. Am. J. Surg. 2019; 217(4): 653-657.
Affiliation
Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu Natal, Durban, South Africa; Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.
INTRODUCTION: The spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature in the specific setting of isolated omental evisceration is limited.
MATERIALS AND METHODS: We reviewed our experience of 244 consecutive patients with established indications for laparotomy over an eight year period at a major trauma centre in South Africa.
RESULTS: Of the 244 patients (93% male, mean age: 27 years), 224 (92) underwent immediate laparotomy (IL). Twenty were initially observed and eventually required a laparotomy (delayed laparotomy, DL). The mean time from injury to decision for laparotomy was <3 h in 92% (224/244), <6 h in 6% (14/244), <12 h 2% (4/244) and <18 h in 1% (2/244). Ninety-eight per cent (238/244) of laparotomies were positive and 96% of the positive laparotomies (229/238) were considered therapeutic. The mostly commonly injured organ encountered on laparotomy were small bowel, stomach and colon.
CONCLUSIONS: The most commonly injures encountered are intestinal and gastric. Clinicians must remain vigilant as injuries may be subtle.