The utility of diagnostic laparoscopy in the evaluation of anterior abdominal stab wounds - 20/08/11
, Patrick J. O'Neill, Ph.D., M.D., F.A.C.S. a, Luis H. Macias, M.D. a, Jordy C. Cox, M.D., F.A.C.S. a, Marc R. Matthews, M.D., F.A.C.S. a, David A. Drachman, Ph.D. b
Corresponding author. Tel.: +1-602-344-5637; fax: +1-602-344-5705Abstract |
Background |
To assess if diagnostic laparoscopy (DL) is superior to nonoperative modes (serial abdominal examination with/without computed axial tomography [CAT] and diagnostic peritoneal lavage) in determining the need for therapeutic laparotomy (TL) after anterior abdominal stab wound (ASW).
Methods |
Retrospective review of ASW patients. Patients were divided into group A (DL/exploratory laparotomy) to identify peritoneal violation (PV) and group B (initial nonoperative modes).
Results |
Seventy-three patients met inclusion criteria. In group A (n = 38), 29 patients (76%) had PV by DL and underwent exploratory laparotomy. Only 10 (35%) underwent TL (sensitivity for PV = 100%; specificity and positive predictive value of PV in determining need for TL = 29% and 33%, respectively). In group B (n = 35), 7 patients (20%) underwent TL, yielding an improved specificity (96%) and positive predictive value (88%).
Conclusions |
We find no role for DL in the evaluation of ASW patients solely to determine PV.
Le texte complet de cet article est disponible en PDF.Keywords : Anterior abdominal stab wounds, Diagnostic laparoscopy, Computed tomography, Diagnostic peritoneal lavage, Hospital charges, Laparotomy, Length of stay, Local wound exploration, Nontherapeutic, Serial abdominal examinations, Therapeutic
Plan
Vol 196 - N° 6
P. 871-877 - décembre 2008 Retour au numéro
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