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Abstract

Background: As early as 1960, (Gerald W. Shaftan,M.D.) advocated “observant and expectant treatment” in the management of penetrating abdominal injury rather than exploratory laparotomy. This was reinforced in 1969 by Nance and Cohn for the abdominal stab wounds (SWs) management. Since that time, selective nonoperative management (NOM) of SWs to the anterior abdomen has become more readily accepted.objective: To assess the feasibility and safety of selective nonoperative management in penetrating abdominal injuries.Patients & Method: prospective study was performed at Al-Imamain Al-Kadhimain Medical City over a two years from (October 2018 to October 2020) the study included patients with penetrating abdominal injuries from level of fifth intercostal space to the level of pubic symphasis. Patients with peritonitis or hemodynamic instability were selected for emergent laparotomy. Clinically conscious patients who were haemodynamically stable and had no signs of peritonitis were evaluated by CT scan with intravenous contrast. Results: During the study, there were 143 patients with penetrating abdominal injuries , (62.22%) underwent an emergency laparotomy. (37.76%) were selected for CT scan evaluation and clinical observation. (7.69%) of them have CT-scan findings of hallow viscous injury and explored. (1.39%) failed for nonoperative management. (28.67%) had been managed nonoperatively successfully. Conclusion: selective nonoperative management of penetrating abdominal injuries can be practiced safely with use of CT scanning.

DOI

10.52573/ipmj.2024.137400

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