تحقیقی پیرامون اعتبار روشهای تشخیصی در ترومای نافذ غیرجنگی شکم و پهلو

ABSTRACT To evaluate the reliability of modalities of management of patients with penetrating civilian abdominal and flank trauma, hospital records of all affected patients, who were managed in Hazrat Rasul-e Akram and Haft-e Tir hospitals in Tehran, have been reviewed over a seven-year period, ending on march 19, 1996. These hospitals are level two trauma centers affiliated to the Iran University of Medical Sciences. One hundred and five patients have been reviewed in this research. The positive predictive value of mandatory laparotomies performed for penetrating traumas to intrathoracic abdomen was high (100%). Thus, this is a reliable modality for the management of these patients. The positive predictive value of mandatory laparotomies performed for evisceration was 67%, which is not considerable. Thus, revision of this indication may be reasonable. In this study, the positive predictive value of routine laparotomies was very low(38%). This reemphasizes the point that routine laparotomies for peritoneal penetration must be avoided, if possible. The positive and negative predictive values of selective laparotomies were very well (91% and 87%). So, it can be recommended that in the management of patients with penetrating abdominal trauma, surgeons should employ diagnostic methods such as “diagnostic peritoneal lavage” (DPL), “imaging” and “observation”, if possible and where applicable.