Management of penetrating injuries of abdomen and its outcome

ObjectiveTo evaluate the clinical profile, management, and outcomes of penetrating abdominal injury. BackgroundPenetrating abdominal trauma is a leading cause of morbidity and mortality worldwide. Prompt recognition and timely intervention are crucial to patient survival. MethodsThis prospective observational study was conducted at a tertiary care government center between September 2020 and October 2022. Patients with penetrating abdominal injuries were evaluated by detailed history, clinical examination, and laboratory and radiological investigations and managed according to standard protocols. The operative findings and postoperative outcomes were also recorded. ResultsA total of 68 patients with penetrating abdominal trauma were studied, with a marked male predominance and peak incidence in the 21-30 year age group. Homicidal stab wounds were the leading cause (85%), while other causes included bullhorn injuries, self-inflicted wounds, and accidental trauma (5% each). Clinical presentations were dominated by peritoneal penetration (67%), omental evisceration (32%), and bowel evisceration (10%). Radiological evaluation revealed diagnostic utility of CECT (50% positivity) compared to FAST (29%) and plain radiography (22%). The mesentery (36%), small bowel (34%), and colon (25%) were the most commonly injured organs. Primary repairs of mesentery (42.5%), small bowel (37.5%), and colon (17.5%) were the main surgical interventions, with diversion stomas required in selected cases. In 13% of patients, no visceral injury was found. Mean hospital stay was 7 days, with an overall mortality of 13.2%. Postoperative complications included respiratory infections, ARDS, abdominal sepsis, surgical site infections, and late complications such as burst abdomen, stoma prolapse, and anastomotic leakage. ConclusionsPenetrating abdominal injuries predominantly affect young adults and are associated with significant morbidity and mortality rates. Early diagnosis, appropriate resuscitation, and timely surgical intervention are cornerstones of management.