• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Surgery

Physical examination sufficient to evaluate abdominal stab wounds

bys25qthea
July 13, 2013
in Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: PD

1. In evaluating abdominal stab wound patients, physical exam alone was sufficient to determine if patients required therapeutic laparotomy. 

2. The sensitivity and specificity of physical exam was higher than that of CT imaging, and were more likely to alter clinical decision making than CT imaging. 

Evidence Rating Level: 1 (Excellent)

Study Rundown: Although some patients with abdominal stab wounds obviously require surgical intervention, some patients are stable enough to observe and evaluate before proceeding further. However, management guidelines for abdominal stab wounds are unclear, and the utility of CT is not established, due to the lack of local soft tissue disruption. This study evaluated the diagnostic utility of CT compared to physical examination in abdominal stab wound patients, and demonstrated that physical exam alone was able to determine whether therapeutic laparotomy was required, or observation alone would  be sufficient. Moreover, the sensitivity and specificity of physical exam was higher than that of CT. One weakness of this study was that the authors did not specify the methodology of physical exam performed on these patients, or who performed the exams. Also, the minimum observation period was only 24 hours, and it is possible that a patient who was discharged may have had a later complication.

Click to read the study in JAMA Surgery

RELATED REPORTS

2 Minute Medicine Rewind June 30, 2025

Evaluating scar outcomes in pediatric burn patients following skin grafting 

Transcatheter closure of patent ductus arteriosus demonstrates similar outcomes compared to surgical repair

Click to read an accompanying editorial

Relevant Reading: The Nonoperative Management of Penetrating Abdominal Trauma

In-Depth [prospective study]: This study examined 249 patients older than 16 years of age with abdominal stab wounds. Patients with extra-abdominal injuries requiring intervention were excluded. The cohort was mostly male patients, with average age of 30.8 years. Most patients had a single stab wound (67.5%), with some patients having up to 6 stab wounds. 18.1% of the initial cohort were unstable and required immediate surgical intervention. 10.8% of patients had only superficial wounds and were discharged from the emergency department were excluded. The remaining 177 patients had a CT and underwent a minimum of  24 hours of observation with nonoperative management.

Of the 177 patients with CT and nonoperative management, 154 required no laparotomy intervention, including 30 patients with solid organ damage that was managed nonoperatively, all of whom were discharged within 48 hours without complication. Three patients eventually had thoracic procedures, and 20 patients underwent abdominal exploration, all based on deterioration of their physical exam. Two patients underwent laparotomy due to CT findings only, both leading to negative laparotomies. The sensitivity and specificity of physical exam for determining if laparotomy is necessary was found to be 100% and 98.7% respectively, compared to only 31.3% and 84.2% for CT imaging.

By James Jiang and Allen Ho

More from this author: Drainage for hemopericardium is safe and reduces hospital stay, Adenotonsillectomy improves behavior in childhood obstructive sleep apnea (CHAT Trial), Plasma-Lyte A improves acid-base status in adult trauma patients, Postoperative complications linked with unplanned hospital readmissions

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

Tags: abdominal injuryctimagingstab woundSurgery
Previous Post

Preterm delivery associated with long-term maternal cardiovascular risk

Next Post

Blindness and visual impairment decreasing worldwide

RelatedReports

Quick Take: Functional Outcome of Intravenous Thrombolysis in Patients With Lacunar Infarcts in the WAKE-UP Trial
Weekly Rewinds

2 Minute Medicine Rewind June 30, 2025

June 30, 2025
Pediatrics

Evaluating scar outcomes in pediatric burn patients following skin grafting 

June 26, 2025
Colchicine may lower the risk of cardiovascular events in patients with coronary disease
Cardiology

Transcatheter closure of patent ductus arteriosus demonstrates similar outcomes compared to surgical repair

June 13, 2025
Weekly Rewinds

2 Minute Medicine Rewind June 9, 2025

June 9, 2025
Next Post
Blindness and visual impairment decreasing worldwide

Blindness and visual impairment decreasing worldwide

Clinical impression not reliable in identifying drug-seeking behavior

Clinical impression not reliable in identifying drug-seeking behavior

Exercise associated with lower pain ratings

Limited cardiovascular effect of diet and exercise in obese type II diabetics

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Artificial intelligence based clinical decision systems are safe and effective for diabetes management
  • Epic Launchpad propels generative-AI into everyday hospital routines
  • #VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.