Henry Ford Hospital Medical Journal


The management of penetrating abdominal wounds has become a necessity in most larger metropolitan hospitals. Most of these wounds are produced by low velocity gunshots, but some are stab wounds. Several recent advances have contributed to the more successful management of penetrating abdominal wounds. These include: 1) improvement in on-site care by various emergency medical services, 2) more rapid transportation of the injured to a facility equipped to care for such patients, 3) vigorous resuscitative and diagnostic measures, 4) prompt and adequate surgical intervention, 5) improvements in anesthesia techniques, and 6) improvements in blood banks. From 1969 to 1974, 843 patients were treated for thoraco-abdominal trauma at the Henry Ford Hospital. This study reviews 210 patients, operated upon during this period, in whom there was a reasonable chance that the wound had penetrated into the abdominal cavity. The following conclusions have been reached: 1. A careful preoperative clinical and radiological evaluation of the patient has led to less than 10% of negative explorations with no mortality and little morbidity. 2. A mortality of 4% is closely related to the degree of peritoneal contamination and not necessarily to the number of organs injured. 3. Although the morbidity in these patients is high, it can be controlled if discovered early and treated properly.