Penetrating Abdominal Trauma Guidelines

Updated: Mar 30, 2022
  • Author: Patrick J Offner, MD, MPH, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Guidelines

Guidelines Summary

WSES guidelines

The World Society of Emergency Surgery (WSES) has published guidelines on bowel trauma diagnosis and management. Highlights of the guidelines on penetrating abdominal trauma including the following [36] :

  • Nonoperative management of penetrating abdominal trauma can be performed at specialized centers provided that the patient is hemodynamically compensated and cooperative. Nonoperative management might be more appropriate for stab wounds than for gunshot wounds.
  • The presence of highly specific CT findings such as extraluminal air, extraluminal oral contrast, or bowel-wall defects warrants prompt surgical exploration.
  • Highly sensitive CT findings such as free fluid in the absence of solid-organ injury, abnormal enhancement of bowel wall, and mesenteric stranding can be used as an adjunct to the clinical picture but should not solely determine management.
  • Intravenous contrast-enhancing CT scanning has equal sensitivity to triple contrast in detecting bowel injury and is favorable in time-sensitive trauma situations.