Penetrating XXXX . A reassessment of mandatory celiotomy.

@entity1 @entity812 @entity29 @entity3511 @entity130
The optimum management of penetrating @entity812 remains controversial. Since 1980 our institution has followed a policy of mandatory celiotomy for back and flank wounds with evidence of fascial penetration. Following this policy, 34 @entity1 underwent celiotomy for back (8), flank (22), or combined (4) area penetrating injuries. Four @entity1 sustained shotgun blasts, eight sustained handgun or @entity130 , and 22 @entity1 were stabbed. All shotgun blasts caused multiple intra-abdominal injuries and five (63%) of the eight gunshot victims had significant intra-abdominal injuries. Only one (5%) of the 22 stab victims had significant @entity3511 . Four (12%) @entity1 died, three of @entity130 . One @entity1 had a @entity29 after a noncontributory abdominal examination. Based on this review, the authors recommend selective management of stab @entity812 . Gunshot wounds continue to warrant mandatory exploration.
