Self-inflicted abdominal stab wounds

Injury. 2003 Jan;34(1):35-9. doi: 10.1016/s0020-1383(02)00084-0.


Background: Self-inflicted abdominal stab wounds (ASWs) are uncommon. The present study aims to characterize the clinical profile of this unique group of psychiatric-surgical patients.

Methods: A retrospective review of 23 patients with intentional self-inflicted ASWs at two urban level I trauma centres during a 10-year period.

Results: Most patients were males (70%), ages ranging from 21 to 82 years (mean 40 years). Seventy-four percent of patients had a previous psychiatric history and prior suicide attempts were common (41%). Half of the patients had a positive admission drug or alcohol screen. Hypotension (systolic blood pressure (SBP) < 90 mmHg) was present in only two patients. Mean injury severity, revised trauma and Glasgow coma scores were 5.8, 7.7 and 14.5, respectively. The most commonly used instrument was a knife (87%). There were 1.5 external wounds per patient located primarily in the right upper quadrant (40%) and right lower quadrant (23%). These were associated with extra-abdominal wounds in 22% of cases. Local wound exploration was positive in 15 patients (65%), who all underwent laparotomy. Injured intra-abdominal or retroperitoneal organs were identified in 10 patients and included the stomach, duodenum, small bowel, colon, mesentery, inferior vena cava (IVC) and psoas muscle with a mean of 1.7 injuries per patient. Wound infection was the only post-operative complication (two patients). All eight patients with a negative local wound exploration were observed without complication. Seventy percent of patients were ultimately transferred to a psychiatric ward with a mean length of stay on the surgical service of 8 days. Only one patient died during admission due to metastatic malignant disease.

Conclusion: Self-inflicted ASWs in suicidal patients can induce significant although most likely non-lethal abdominal and retroperitoneal injuries. This observation should guide the trauma surgeon when treating such patients.

Publication types

  • Multicenter Study

MeSH terms

  • Abdominal Injuries / epidemiology
  • Abdominal Injuries / psychology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Glasgow Coma Scale
  • Humans
  • Injury Severity Score
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / psychology
  • Suicide, Attempted / psychology
  • Urban Health
  • Wounds, Stab / psychology*