Comparative Study between Operative and Conservative Management of Penetrating Anterior Abdominal Stab Injuries


  • Ahmad Yahia Abdel Dayem Department of General and Laparscopic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt
  • George A. N. Aiad Department of General Surgery, Cairo University, Giza, Egypt
  • Hany M. S. Mikhail Department of Surgery, Cairo University Medical School, Cairo University, Giza, Egypt
  • Mohammed Elshwadfy Department of General Surgery, Cairo University, Giza, Egypt
  • Ahmad Abd Al Aziz Department of General Surgery, Cairo University, Giza, Egypt



Penetrating abdominal trauma, Selective non-operative management, Safety and feasibility, Unnecessary laparotomy


Background: Presently, non-operative management of penetrating abdominal stab injuries has been standardized in several trauma centers. This strategy has appromising outcome conserving decreasing morbidity.

Aim of the work: This study aimed to assess the safety and feasibility of SNOM of patients having penetrating abdominal stab injuries not indicating emergent laparotomy and  to identify a protocol for selection of patient candidates for non-operative management in a tertiary care hospital in Egypt.

Patients & Methods: This is a prospective study that involved patients who presented to the casualty department of Kasr Elainy teaching Hospital, in the period from August 2018 to August 2020, for management of a penetrating abdominal Stab injuries. Fully conscious, haemodynimacally stable patients were included. Eligible patients were allocated to either SNOM group or immediate operative management (IOM) group.

Results: SNOM group included64 patients and IOM group included 40 patients. The age of the patients ranged from 16 to 49 years with a mean of 33±6.8 years, and the majority were males (99%). SNOM failed in 4/69 patients (5.7%) who required delayed laparotomy for peritonitis (2 cases) and HB drop and haemodynamic instability (2 cases). In IOM group, only 3 cases had therapeutic laparotomies (7.3%). The remaining cases had unnecessary laparotomies (92.7%). Statistically significant higher LOS was seen in SNOM group (p<0.05). However, less unnecessary laparotomies and lower incidences of complications were noted (p<0.01).

Conclusion: vital signs together with abdominal examination are the most important clinical criteria in decision making in penetrating abdominal stab injury patients  When surgery is not absolutely indicated, SNOM is a safe and feasible approach in management of penetrating abdominal stab injury by following proper management algorithm and selection criteria.


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How to Cite

Dayem AYA, Aiad GAN, Mikhail HMS, Elshwadfy M, Al Aziz AA. Comparative Study between Operative and Conservative Management of Penetrating Anterior Abdominal Stab Injuries. Open Access Maced J Med Sci [Internet]. 2022 Mar. 2 [cited 2022 Jul. 1];10(B):821-5. Available from:

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