Comparison of routine laparotomy results performed by solo surgeons with suspicious computed tomography and inflammatory markers in penetrating abdominal stab wounds in a suburban area: a retrospective cohort of 91 patients
Signa Vitae, cilt.21, sa.5, ss.49-54, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 5
- Basım Tarihi: 2025
- Doi Numarası: 10.22514/sv.2025.065
- Dergi Adı: Signa Vitae
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE
- Sayfa Sayıları: ss.49-54
- Anahtar Kelimeler: Penetrating, Stab, Trauma, Computed tomography, Nontherapeutic laparotomy
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: One of the most encountered challenges in trauma is predicting an intraabdominal hollow viscus injury or foreseeing a nontherapeutic laparotomy in patients with penetrating abdominal stab injuries. Suspicious computed tomography (CT) findings like free air and free fluid can leave surgeons in doubt about an injury’s presence. This study aimed to compare the therapeutic and nontherapeutic laparotomy results in patients with penetrating abdominal stab wounds who had suspicious intraabdominal hollow viscus injury CT findings. Methods: Retrospective and single-center cohort of all patients with penetrating abdominal stab wounds between January 2012 and January 2023 in Gebze Fatih State Hospital were evaluated. All patients had CT evaluation and complete blood count (CBC) and then underwent laparotomy. The laparotomies were classified as therapeutic or nontherapeutic and the patients were grouped according to the results.We then analyzed the diagnostic value of CT and initial CBC on laparotomy. Results: A total of 91 patients with penetrating abdominal stab wound who underwent laparotomy were included in the study. Of the 91 patients, 56 (61.5%) had nontherapeutic laparotomies, and 35 (38.4%) had therapeutic laparotomies for hollow viscus injury. The CT findings of intraabdominal free air or fluid were present in all patients but were not significant predictors of hollow viscus injury (p value, 0.06, 0.09, respectively). The initial CBC values, neutrophil/lymphocyte ratio and platelets/lymphocyte ratio were also not significant predictors (p-value, 0.49, 0.37, respectively). Conclusions: In this retrospective study of abdominal penetrating stab wound management, we were not able to use the CT and CBC to distinguish the injuries that require therapeutic laparotomy for hollow viscus injury.