Comparison of routine laparotomy results performed by solo surgeons with suspicious computed tomography and inflammatory markers in penetrating abdominal stab wounds in a suburban area: a retrospective cohort of 91 patients

Çolapkulu Akgül N., Akgül C., Güneş A., Yaşar S.

SIGNA VITAE, vol.21, no.5, pp.49-54, 2025 (Scopus)

  • Publication Type: Article / Article
  • Volume: 21 Issue: 5
  • Publication Date: 2025
  • Doi Number: 10.22514/sv.2025.065
  • Journal Name: SIGNA VITAE
  • Journal Indexes: Scopus, Academic Search Premier, CAB Abstracts, Central & Eastern European Academic Source (CEEAS), Veterinary Science Database
  • Page Numbers: pp.49-54
  • Kocaeli University Affiliated: Yes

Abstract

Abstract

Background: One of the most encountered challenges in trauma is predicting an

intraabdominal hollow viscus injury or foreseeing a nontherapeutic laparotomy in

patients with penetrating abdominal stab injuries. Suspicious computed tomography

(CT) findings like free air and free fluid can leave surgeons in doubt about an

injury’s presence. This study aimed to compare the therapeutic and nontherapeutic

laparotomy results in patients with penetrating abdominal stab wounds who had

suspicious intraabdominal hollow viscus injury CT findings. Methods: Retrospective

and single-center cohort of all patients with penetrating abdominal stab wounds between

January 2012 and January 2023 in Gebze Fatih State Hospital were evaluated. All

patients had CT evaluation and complete blood count (CBC) and then underwent

laparotomy. The laparotomies were classified as therapeutic or nontherapeutic and the

patients were grouped according to the results.We then analyzed the diagnostic value

of CT and initial CBC on laparotomy. Results: A total of 91 patients with penetrating

abdominal stab wound who underwent laparotomy were included in the study. Of the 91

patients, 56 (61.5%) had nontherapeutic laparotomies, and 35 (38.4%) had therapeutic

laparotomies for hollow viscus injury. The CT findings of intraabdominal free air or fluid

were present in all patients but were not significant predictors of hollow viscus injury

(p value, 0.06, 0.09, respectively). The initial CBC values, neutrophil/lymphocyte ratio

and platelets/lymphocyte ratio were also not significant predictors (p-value, 0.49, 0.37,

respectively). Conclusions: In this retrospective study of abdominal penetrating stab

wound management, we were not able to use the CT and CBC to distinguish the injuries

that require therapeutic laparotomy for hollow viscus injury.

Keywords

Penetrating; Stab; Trauma; Computed tomography; Nontherapeutic laparotomy