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Correspondence and Brief Communications
June 2002

Stop the Pendulum—Reply

Arch Surg. 2002;137(6):746. doi:

In reply

Digital exploration of stab wounds in the left thoracoabdominal region is a simple, easy, and accurate procedure that is performed with local anesthesia. Diaphragmatic injury caused by stab wounds is always in front of the chest wall. A surgeon does not need to assess the entire hemidiaphragm to rule out diaphragmatic injury.

We all agree that minimally invasive surgery plays a large role in diagnosing injuries to the diaphragm. We believe that thoracoscopy or laparoscopy must be used for stable patients with gunshot wounds to the thoracoabdominal region and without abdominal signs or symptoms, or when the digital exploration of stab wounds is inconclusive.