Bowel perforation following stab forms an important component of emergency duty surgeons, victims varying from young to elderly age groups. Over the years, we have seen many changes in the diagnosis and management of a case of perforation.
MATERIALS AND METHODS
This is a retrospective observational study done in Travancore Medical College between January 1, 2015, to December 30, 2016, who presented with acute abdomen and diagnosed to have perforated bowel. The clinical presentation, imaging features, diagnosis, management and complications of all these patients were analysed.
The mean age was 33.5 with majority being males. Homicidal stab injuries accounted for most of the injuries (62.5%). 96 patients underwent laparotomy, and among which, the procedure was therapeutic in 72 patients. Peritoneal perforation was the best predictor of a therapeutic laparotomy with a high sensitivity and positive predictive value (100 and 80%, respectively). Small bowel was commonly injured. The mean postoperative stay was 8.25 days and there was no postoperative mortality.
We should avoid negative laparotomies, but not at the expense of delayed diagnosis and treatment. Diagnostic laparoscopy, which is now in practice is the best modality to avoid negative laparotomies.
Penetrating Injury, Bowel Perforation, Abdominal Injury.