Use of computed tomography in the initial evaluation of anterior abdominal stab wounds

Am J Surg. 2011 Dec;202(6):690-5; discussion 695-6. doi: 10.1016/j.amjsurg.2011.06.032. Epub 2011 Oct 28.


Background: The purpose of this study was to assess the ability of computed tomography (CT) to facilitate initial management decisions in patients with anterior abdominal stab wounds.

Methods: A retrospective review was conducted of patients with anterior abdominal stab wounds who underwent CT over 4.5 years. Any abnormality suspicious for intra-abdominal injury was considered a positive finding on CT.

Results: Ninety-eight patients met the study's inclusion criteria. Positive findings on CT were noted in 30 patients (31%), leading to operative intervention in 67%. Injuries were confirmed in 95% of cases, but only 70% were therapeutic. Ten patients had nonoperative management despite positive findings on CT, including 5 patients with solid organ injuries. One patient underwent operative intervention for clinical deterioration, with negative findings. No computed tomographic evidence of injury was noted in the remaining 68 patients (69%), but 1 patient was noted to have a splenic injury while undergoing operative evaluation of the diaphragm. All remaining patients were treated nonoperatively with success.

Conclusions: In patients with anterior abdominal stab wounds, CT should be considered to facilitate initial management decisions, as it has the ability to delineate abnormalities suspicious for injury.

Publication types

  • Comparative Study

MeSH terms

  • Abdominal Injuries / diagnostic imaging*
  • Abdominal Injuries / surgery
  • Adolescent
  • Adult
  • Aged
  • Child
  • Decision Making
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Retrospective Studies
  • Surgical Procedures, Operative
  • Tomography, X-Ray Computed / statistics & numerical data*
  • Trauma Severity Indices
  • Wounds, Stab / diagnostic imaging*
  • Wounds, Stab / surgery
  • Young Adult