2016, Number 1
Revista Cubana de Cirugía 2016; 55 (1)
López AY, Fernández GA, Sánchez RGE
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ABSTRACTIntroduction: penetrating traumatic lesions of the abdomen usually leads to damage in the abdominal cavity from a wound caused with a white weapon or other sharp-piercing object. This circumstance constitutes a health problem and one of the most common reasons for emergency consultation in surgery. This type of lesions was the fifth leading cause of death for both sexes in Cuba in 2014.
Objective: to evaluate the criteria indicative of laparotomy in patients with abdominal wounds caused with a white weapon.
Method: a diagnostic modalities assessment study was carried out in patients who underwent exploratory laparotomy for abdominal wound caused by a white weapon. The target group was made up by the patients with this type of lesions. The sample consisted of surgery patients (n= 80). Several clinical and complementary elements indicative of laparotomy were assessed before the possibility of significant organic lesions.
Results: the average age was 32 years, with a predominance of males (91.3 %). 41.3% of the patients showed exogenous intoxication signs, only 51.25% of laparotomies were therapeutic ones. The presence of hypovolemic shock (84.2 %), clinical signs of ongoing bleeding (82.4 %) and obvious gastrointestinal tract perforation (90.9 %) showed better sensitivity, specificity and positive predictive values. Among the complementary tests, laparoscopy showed values of sensitivity (89.5 %) and specificity (81.8 %) higher than the others.
Conclusions: hypovolemic shock, signs of ongoing bleeding and signs of obvious gastrointestinal tract perforation, and laparoscopy showed the best results as criteria indicative of laparotomy in abdominal stab wounds.