[Management of abdominal stab wounds].

In general, laparotomy is accepted as treatment of choice for abdominal shot wounds. However, the management of abdominal stab wounds is controversial. In order to study the concept of laparotomy for penetrating abdominal trauma our patient collective was analyzed retrospectively. From 1st January 1985 to 31st December 1993 we performed laparotomy in 30 cases of abdominal stab wounds. 24 patients were victims of violence. In 6 patients the cause of injury was a suicidal attempt. Laparotomy was negative in 27% of cases. In most cases explorative laparotomy showed injuries of the vessels (n = 12) and the intestines (n = 9). The mortality rate was 6.7%. None of the fatal cases was caused by negative laparotomy. During a mean follow-up time of 54 months none of the patients showed disorders of late onset after negative laparotomy. Because of the limited diagnostic possibilities to rule out intestine injury and minimal morbidity of negative laparotomies we continue to favour laparotomy in the management of penetrating abdominal trauma.