OUR RESULTS OF CONSERVATIVE MANAGEMENT OF STAB WOUNDS PENETRATING THE PERITONEUM

Conservative management of stab wounds penetrating the peritoneum reduces the incidence of negative laparatomy. The records of 36 cases with penetrating abdominal stab wounds were reviewed. Decision of operation was based on evolving physical signs with radiographic findings.. Diagnostic laparascopy was performed on two cases with penetrating abdominal stab wounds. Laparatomy was performed on 27 cases (75%), remaining 9 cases(25%) were treated conservatively and discharged after an observation period. In two cases (5.6%), laparatomy were non-therapeutic. There were various intraabdominal injuries in the remaining 25 cases. The most injured organ was small intestine. The average length of hospitalisation was 8.4 days for cases underwent laparatomy and 2.7 days for conservative approached cases. In conclusion; our results show that the rate of negative laparatomy was lowered to 5.6 percent when compared with classical approach in which mandatory laparotomy was made for every stab wound penetrating the peritoneum. In some of these cases diagnostic laparascopy may be helpful in selection of patients for operation.

PERÝTONA PENETRE KESÝCÝ DELÝCÝ ALET YARALANMALARINDA KONSERVATÝF TEDAVÝ SONUÇLARIMIZ

Peritona penetre kesici delici alet yaralanmalarýnda konservatif tedavi uygulamasý negatif laparotomi oraným azaltmaktadýr. Peritona penetre kesici delici alet yaralanmasý olan 36 olgu retrospektif olarak incelendi. Ameliyat kararý fizik muayene bulgularý esas alýnarak verildi. Ancak radyografi ve ultrasonografiden de yararlanýldý. Ýki vakaya diagnostik laparoskopi uygulandý. 27 olguya (%75) laparotomi uygulandý. Geri kalan 9 olgu (%25) konservatif olarak tedavi gördü ve yeterli bir takip süresinden sonra taburcu edildi. Laparotomi, olgularýn ikisinde nonterapötikti. Diðer 25 olguda en fazla ince barsak olmak üzere deðiþik karýn içi organlarda yaralanma saptandý. Laparotomi uygulanan olgularýn ikisinde komplikasyon görüldü. Ortalama hastanede yatýþ süresi laparotomi uygulanan olgularda 8.4 gün, konservatif tedavi uygulananlarda ise 2.7 gün oldu. Sonuç olarak; peritona penetre kesici delici alet yaralanmalarýnda hastanýn durumuna göre konservatif yaklaþým yanýnda, gerekli olgularda diagnostik laparoskopi uygulamasý negatif laparotomi oranýný azaltmaktadýr.