Background/Purpose: Abdominal trauma is one of the major causes of death in trauma patients; abdominal trauma is the second leading cause of trauma deaths. This study was designed to evaluate the role of conservative management for selected cases of vitally stable patients who presented with stab penetrating trauma to the anterior abdomen with no evidence of peritonitis; hence avoiding unnecessary laparotomies aiming at reducing the hospital stay time and reducing morbidity and mortality.
Patients and methods: This prospective study was carried on 56 patients from May 2013 to October 2014. The work was done in the Emergency unit of the Alexandria Main University Hospital with stab penetrating trauma to the anterior abdomen. Patients were selected for "selective non operative management SNOM."
Results: 44 patients were males (78.57%) and 12 patients were females (21.42%). 24 patients (42.85%) were less than 30 years, 22 patients (39.28%) from 30-45 years and 10 patients (17.85%) more than 45 years. The age ranged from 18 to 60 years with mean age of 33.3. Sixteen cases (28.5%) had suspicious abdominal examination after admission. On exploration 11 cases were positive and 5 cases were negative. 34 cases (60.7%) had free abdominal examination on admission, 26 cases were managed conservatively without complications, and hence they were saved unnecessary laparotomy while 8 cases were explored for other causes.
Conclusions: SNOM for abdominal stab wounds is no longer a novelty; its practice is now standard in most trauma centers. Vitally unstable cases with suspected internal haemorrhage should be immediately transferred to do exploratory laparotomy. It was concluded that SNOM of abdominal stab wounds is safe and preferred strategy for minimizing the days in hospital, hospital costs, as well as avoiding unnecessary laparotomies.