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Conservative Management of Penetrating Abdominal Wounds

Kenneth J. Printen, MD; Robert J. Freeark, MD; William C. Shoemaker, MD
Arch Surg. 1968;96(6):899-901. doi:10.1001/archsurg.1968.01330240045010.
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CRITERIA for exploration of the abdomen in acute injuries have not been well defined. It is generally accepted that gunshot wounds of the abdomen should be explored as soon as the patient's condition permits. However, there has not been general agreement in the management of abdominal stab wounds. Penetration of the abdominal wall has been suggested as the major criterion. Various x-ray diagnostic aids to determine if penetration exists have been proposed; these include injection of radiopaque material through a catheter placed deep into the wound, diagnostic peritoneal lavage, and probing of the wound.1-3 However, none of these methods has met with universal acceptance.

During the past eight years, the Department of Surgery of Cook County Hospital has maintained a policy of exploring only those abdominal stab wounds with physical findings suggestive of intraperitoneal injury. The present communication details experience with evaluation and treatment of stab wounds of the


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