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July 1967

Management of Abdominal Stab WoundsRoentgenographic Technique for Diagnosis of Peritoneal Penetration

Arch Surg. 1967;95(1):27-29. doi:10.1001/archsurg.1967.01330130029006

THE MANAGEMENT of stab wounds of the abdomen in civilian practice is presently a subject of controversy.1 Those who propose immediate laparotomy in all cases of suspected peritoneal violation have statistical evidence to support the thesis that exploration is the preferred method of management.2 Indeed, immediate exploration has been, until recently, a surgical tenet. There are now scattered reports of expectant management of such injuries with equally impressive statistical evidence of success.3 In any large metropolitan hospital, stab wounds of the abdomen are a common clinical entity. In our hospital we see approximately 100 stab wounds of the abdomen each year. Until recently we have been firm practitioners of immediate exploration with acceptable morbidity and mortality (unpublished data). However, upon reviewing our previous experience, it has become apparent that a great economic saving could be effected if a safe method of diagnosis were established for the nonpenetrating

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