Evisceration following XXXX : analysis of 66 cases.

@entity1 @entity542 @entity1661 @entity2980 @entity1344 @entity298 @entity130
BACKGROUND: Abdominal stab wounds with evisceration remain an indication for emergency laparotomy. The purpose of this study was validate a policy of mandatory laparotomy for organ evisceration and a policy of selective nonoperative management with serial physical abdominal examination for omentum evisceration. METHODS: The charts of 379 @entity1 with @entity2980 who presented to our Level I @entity130 center over a 3-year (January 2005 to December 2007) period were retrospectively reviewed. Altogether, 66 (17.4%) @entity1 with evisceration were identified and included in the study. Indications for mandatory laparotomy were @entity298 , @entity1344 , organ evisceration, and a high spinal cord or severe @entity542 with an @entity1661 wound. Further data gathered included the organ eviscerated, intraabdominal organs injured, and complications. Injury severity was categorized using the revised @entity130 score (RTS), injury severity score (ISS), and penetrating abdominal index (PATI). RESULTS: Organ and omentum evisceration occurred in 35 (53%) and 31 (47%) @entity1 , respectively. Organs eviscerated were as follows (number of @entity1 ): small bowel in 27 (40.9%), stomach in 2 (3%), colon in 1 (1.5%), small bowel and stomach in 2 (3%), and small bowel and colon in 3 (4.5%). The mean RTS, ISS, and PATI scores were 7.71, 13.74, and 8.26, respectively. Only two (5.7%) @entity1 with organ evisceration underwent a negative laparotomy. In total, 23 @entity1 with omentum evisceration (21 with @entity298 , 1 with a @entity542 , 1 who failed abdominal observation) underwent therapeutic laparotomy. Six @entity1 with omentum evisceration were managed successfully nonoperatively. Two @entity1 with left thoracoabdominal omentum evisceration underwent delayed laparoscopy, which revealed a @entity130 in one @entity1 . Overall, 57 (86.4%) @entity1 with evisceration had an intraabdominal injury that required repair. CONCLUSIONS: Evisceration should continue to prompt operative intervention. An exception can be made to a select few @entity1 with omentum evisceration with benign abdominal findings.
