@article{ref1,
title="Expectant management in delayed presentation of war casualties with penetrating abdominal trauma",
journal="Injury",
year="2021",
author="Farraj, Moaad and Bramnick, Zakhar and Kruchin, Boris and Gedalia, Uri and Dar, Ron and Hussein, Hisham and Kvasha, Anton and Waksman, Igor",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: While the management of acute civilian abdominal injuries is well established, The literature regarding the management of battle-related abdominal injuries presented in a delayed fashion is scarce. The objective of this study was to investigate the safety of non-operative management approach in delayed evacuation of battle-related abdominal injuries. <br><br>METHODS: Clinical records of thirty-seven hemodynamically normal patients with battle related injuries and Computed Tomography (CT) findings of penetrating abdominal trauma were retrospectively studied. <br><br>RESULTS: All 37 patients suffered penetrating abdominal injuries during the civil war in Syria. In this complex scenario, the casualties presented after a minimum 12-hour delay to our hospital. All patients had abnormal abdominal CT scans with no clinical peritoneal signs. Twenty-one [of the 37] patients exhibited 29 hard signs on CT scan. Of these, 17 patients were treated non-operatively and 4 underwent exploratory laparotomy (of which 2 were non-therapeutic). Sixteen patients exhibited a total of 75 soft signs on CT scan; 15 were treated non-operatively and one underwent non-therapeutic laparotomy. No complications were recorded in either the operative or non-operative groups. In total, 32 patients (86%) were treated non-operatively. Five patients (14%) underwent exploratory laparotomy (3 of which were non-therapeutic). Length of stay was dependent on the unique requirements of each individual patient as determined by the state department for returning across the border. <br><br>CONCLUSION: We propose that in battle related casualties, acute survivable penetrating abdominal trauma may be safely treated non-operatively in selected patients who are hemodynamically normal and in whom there is an absence of abdominal pain or tenderness on repeated clinical assessment.<p /> <p>Language: en</p>",
language="en",
issn="0020-1383",
doi="10.1016/j.injury.2021.11.030",
url="http://dx.doi.org/10.1016/j.injury.2021.11.030"
}