(no subject)

[Robert F. Smith]

I assume you are not seeing a large volume of these injuries since it sounds
like you are taking every one of them to the OR. Roughly half of anterior
stab wounds should prove not even to penetrate the peritoneum, and half of
the ones that do should prove not to have an injury requiring surgical
intervention.

At CCH we do a DPL not to establish penetration, but using a count of
100,000 rbc to show signs of an "injury" as with blunt trauma. We do this in
an attempt to have earlier identification of those patients who will to on
to develop peritonitis or other indications for a lap. Dr. Nagy can share
our exact statistics but there are relatively few patients that meet this
criteria for exploration. The other patients who we cannot rule out
penetration are observed.

Robert F. Smith, M.D.,MPH
Department of Trauma
Cook County Hospital
----- Original Message -----
From: "hairul ahmad" <hairul_ahmad@hotmail.com>
To: <trauma-list@trauma.org>
Sent: Thursday, August 31, 2000 9:27 PM
Subject: (no subject)


> What does the member think of the place of laparoscopy (vs laparotomy) in
a
> stable patient with penetrating abdominal injury.? Our practice is to use
> laproscopy to establisk peritoneal breach. Once this is confirmed we then
to
> proceed to laparotomy - even if the laparoscopy is normal. What is the
> general consensus in this situation.
>
>
>
> Hairul AHmad
> Melbourne, Victoria
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