Salim et al used CT scan to evaluate patients with stab wounds to the anterior abdomen. This can help to triage patients and to identify patients who should undergo early laparotomy. The authors are from the University of Southern California in Los Angeles.


Patient selection: stable with one or more anterior abdominal stab wounds and without flank, back or thoracic wounds


Local exploration of the wound may be unreliable and difficult to perform in certain individuals.


The authors used oral contrast only and not triple contrast (oral, intravenous, rectal).


Indications for early laparotomy - any of the following identified on CT scan:

(1) pneumoperitoneum

(2) free fluid

(3) extravasated contrast material

(4) involvement of thorax

(5) liver injury

(6) splenic injury

(7) clear trajectory of tract towards bowel or other viscus


Indications for early discharge:

(1) absence of fascial penetration

(2) negative CT scan with stable patient


A person who is discharged should be instructed to return if there are any signs of deterioration.


If in doubt the patient was observed with serial examinations..


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