Search Our Scientific Publications & Authors

Hernia 2022 Jan 6. Epub 2022 Jan 6.

Department of Digestive Surgery, University Hospital of Dijon, 14 Rue Paul Gaffarel, 21000, Dijon, France.

Purpose: Abdominal wall injuries (AWI) is a clinical and radiological diagnosis of fasciomuscular and at times cutaneous defects after abdominal trauma. Their severity encompasses a spectrum of parietal defects, with the most severe being a burst abdomen with eviscerated organs. With the wide use of CT scans in trauma settings, their incidence is being more recognized. Read More

Surg Endosc 2022 05 2;36(5):2801-2808. Epub 2021 Jun 2.

Department of Gastrointestinal, Metabolic and Surgical Oncology, University Hospital Nancy Brabois, Rue du Morvan, 54511, Vandoeuvre-Les-Nancy, France.

Background: The management of hemodynamically stable patients with anterior abdominal stab wounds (AASW) is debated. Mini-invasive techniques using laparoscopy and non-operative management (NOM) have reduced the rate of nontherapeutic laparotomies after AASW leading to unnecessary morbidity. The aim of this study was to determine with a systematic diagnostic laparoscopy of peritoneal penetration (PP), patients who do not require abdominal exploration in the management of stable patient with an AASW. Read More

Injury 2021 Feb 2;52(2):253-255. Epub 2021 Jan 2.

Department of Surgery, University of KwaZulu Natal, Durban, South Africa. Electronic address:

Introduction: Pneumoperitoneum on chest radiograph (CXR) following abdominal stab wounds (SW) is generally considered as surrogate evidence of viscus perforation and an absolute indication for laparotomy. The exact yield of this radiographic finding is unknown.

Materials And Methods: A retrospective study was conducted on all patients who presented with abdominal SW with no peritoneal signs but had pneumoperitoneum alone who underwent mandatory laparotomy from December 2012 to October 2020 at a major trauma centre in South Africa. Read More

J Laparoendosc Adv Surg Tech A 2021 Nov 11;31(11):1262-1268. Epub 2021 Jan 11.

Department of Gastrointestinal Surgery, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Trauma is a leading cause of death in young patients. The prevalence of blunt and penetrating trauma varies widely across the globe. Similarly, the global experience with laparoscopy in trauma patients also varies. Read More

S Afr J Surg 2020 Sep;58(3):150-153

Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.

Background: Knife wounds are common and represent a major burden to the South African healthcare system. This study reviews trends in spectrum, management and outcome of these injuries at a single trauma centre in KwaZulu-Natal(KZN).

Method: The regional hybrid electronic registry (HEMR) was reviewed for the period January 2013 - December 2018, and all patients who suffered a knife-related assault were identified and reviewed. Read More

Chirurg 2020 Jul;91(7):567-575

Universitätsklinik für Allgemeine‑, Viszeral- und Transplantationschirurgie, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland.

Background: The range of indications for laparoscopic procedures has been continuously widened in recent years. At the same time, however, the diagnostic and therapeutic role of laparoscopy in the management of blunt and penetrating abdominal trauma remains controversial.

Methods: A systematic literature search was carried out in PubMed from 2008 to 2019 on the use of laparoscopy in blunt and penetrating abdominal trauma. Read More

World J Clin Cases 2019 Oct;7(20):3271-3275

Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-si 28644, South Korea.

Background: A penetrating injury of a hollow viscus is an obvious indication for an exploratory laparotomy, but is not typically an indication for endoscopic treatment.

Case Summary: A 27-year-old man visited the emergency department with a self-inflicted abdominal stab wound. Injuries to the colon and ileum were detected, but an injury to the second portion of the duodenum was missed. Read More

Trauma Surg Acute Care Open 2019 29;4(1):e000334. Epub 2019 Jun 29.

Department of Surgery, Stanford University, Stanford, California, USA.

Case Presentation: A 38-year-old man was brought in by ambulance as a trauma activation after sustaining a self-inflicted stab wound in the left upper quadrant with a kitchen knife. His primary survey was unremarkable and his vital signs were normal. Secondary survey revealed a 2 cm transverse stab wound inferior and medial to the left nipple. Read More

Isr Med Assoc J 2019 May;21(5):330-332

Department of Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.

Background: Selective management of stable patients with anterior abdomen stab wounds (AASWs) has become a gold standard management approach throughout the world. Evidenced-based options for supporting selective management include clinical follow-up, local wound exploration with or without diagnostic peritoneal lavage, diagnostic laparoscopy, and abdominal computerized tomography. The presence of multiple AASWs might signify a more aggressive attack and limit the safety of a selective management approach. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2019 Feb;31(2):178-181

Department of Acute Abdominal Surgery (General Surgery of Integrated Traditional Medicine and Western Medicine), First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, China.

Objective: To explore the clinical effect of laparoscopic exploration in the diagnosis and treatment of abdominal open trauma.

Methods: Patients with abdominal open trauma admitted to the First Affiliated Hospital of Dalian Medical University from August to December in 2018 were enrolled. According to different exploration methods, 11 patients undergoing laparoscopic exploration were grouped into laparoscopy group and 20 patients undergoing exploratory laparotomy were grouped into laparotomy group. Read More

Am J Emerg Med 2018 08 2;36(8):1405-1409. Epub 2018 Feb 2.

Kanuni Sultan Suleyman Training and Research Hospital, Department of General Surgery, Turkey.

Introduction: The current literature and guidelines recommend that determination of peritoneal violation is done first in cases of anterior abdominal stab wounds. The primary endpoint of this study was to determine the reliability of computed tomographic (CT) tractography to assess peritoneal violation in anterior abdominal stab wounds. The secondary endpoint is to compare local wound exploration between conventional CT and CT tractography in the evaluation of peritoneal violation. Read More

World J Surg 2018 01;42(1):99-106

Department of Surgery, University of Southern California, Los Angeles, CA, USA.

Background: In hypotensive patients with thoracoabdominal penetrating injuries, trauma surgeons often face a considerable dilemma, which cavities and when to explore. We hypothesized that the Focused Assessment with Sonography for Trauma (FAST) would be accurate enough to determine the need and sequence of cavity exploration.

Methods: We conducted a 4-year retrospective study at a level 1 trauma center with high penetrating trauma volume. Read More

Emerg (Tehran) 2017 11;5(1):e34. Epub 2017 Jan 11.

Department of Emergency Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Screening of patients with anterior abdominal penetrating trauma in need for laparotomy is an important issue in management of these cases. This study aimed to compare the accuracy of abdominal wall ultrasonography (AWU) and local wound exploration (LWE) in this regard.

Methods: This diagnostic accuracy study was conducted on ≥ 18 year-old patients presenting to emergency department with anterior abdominal stab wound and stable hemodynamics, to compare the characteristics of AWU and LWE in screening of patients in need of laparotomy. Read More

J Visc Surg 2016 Aug 16;153(4 Suppl):69-78. Epub 2016 Jun 16.

Département de Chirurgie Digestive et de l'Urgence, CHU de Grenoble, 38043 Grenoble cedex 09, France.

This is a single center retrospective review of abdominal or abdomino-thoracic penetrating wounds treated between 2004 and 2013 in the gastrointestinal and emergency unit of the university hospital of Grenoble, France. This study did not include patients who sustained blunt trauma or non-traumatic wounds, as well as patients with penetrating head and neck injury, limb injury, ano-perineal injury, or isolated thoracic injury above the fifth costal interspace. In addition, we also included cases that were reviewed in emergency department morbidity and mortality conferences during the same period. Read More

J Trauma Acute Care Surg 2016 08;81(2):307-11

From the Department of Surgery, Sefako Makgatho Health Science University, Dr George Mukhari Academic Hospital, Pretoria, South Africa.

Background: Organ evisceration after penetrating abdominal trauma (PAT) carries a high rate of significant intra-abdominal injuries. There is uniform agreement that organ evisceration warrants immediate laparotomy. Nonoperative management of stable asymptomatic patients with evisceration is associated with a high failure rate. Read More

Trauma Mon 2015 Nov 23;20(4):e24844. Epub 2015 Nov 23.

Department of Surgery, Guilan Surgery Research Center, Guilan University of Medical Sciences, Rasht, IR Iran.

Background: The current approach in stab wounds of the anterior abdominal wall is still unclear.

Objectives: The goal of this study was to evaluate serial clinical examinations of patients with abdominal wall stab wounds referred to Poursina Hospital in Rasht.

Patients And Methods: In a cross sectional study, 100 cases with stab wounds to the anterior abdominal wall were examined serially (admission time, 4, 8, 12, and 24 hours) after wound exploration. Read More

Chirurgia (Bucur) 2015 Nov-Dec;110(6):554-8

Introduction: The pancreatic injuries have fortunately a low frequency, but when present associate multiple intraabdominal lesions, and carry a significant morbidity and mortality. The aim of this study is to underline the significant morbidity associated with high grade pancreatic injuries.

Case Report: Female patient, 36 years old, with penetrating abdominal trauma due to domestic violence was referred to our center from a regional county hospital, after multiple laparotomies, hemodynamically unstable, with multiple organ failure. Read More

J Laparoendosc Adv Surg Tech A 2016 Jan 9;26(1):27-31. Epub 2015 Dec 9.

Department of General Surgery, Abassia Faculty of Medicine, Ain Shams University , Cairo, Egypt .

Background: In many trauma centers there is an ongoing controversy over the way of managing patients with penetrating abdominal injuries. This study was constructed to evaluate the role of diagnostic laparoscopy performed with local anesthesia for the management of penetrating abdominal injury.

Patients And Methods: Thirty hemodynamically stable patients with a penetrating stab wound in the anterior abdominal wall were included in this study after consent was obtained. Read More

Eur J Trauma Emerg Surg 2016 Dec 1;42(6):671-675. Epub 2015 Dec 1.

Trauma Service, The Alfred Hospital, Melbourne, VIC, Australia.

Introduction: The management of haemodynamically stable patients who present following a penetrating abdominal injury (PAI) remains variable between mandatory surgical exploration and more selective non-operative approaches. The primary aim of this study was to assess compliance with an algorithm guiding selective non-operative management of haemodynamically stable patients with PAI. The secondary aim was to examine the association between compliance and unnecessary laparotomies. Read More

Ugeskr Laeger 2015 Oct;177(44):V12140678

A mentally ill 46-year-old woman was admitted to our hospital because of a self-inflicted stab wound to the abdomen. Diagnostic laparoscopy was performed and the peritoneum was found to be intact. She was discharged in good physical health the next day. Read More

Am Surg 2015 Oct;81(10):1034-8

Division of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Stab wounds (SW) to the abdomen traditionally require urgent exploration when associated with shock, evisceration, or peritonitis. Hemodynamically stable patients without evisceration may benefit from serial exams even with peritonitis. We compared patients taken directly to the operating room with abdominal SWs (ED-OR) to those admitted for serial exams (ADMIT). Read More

J Trauma Acute Care Surg 2015 Jun;78(6):1076-83; discussion 1083-5

From Department of Surgery (T.D.B), Stanford University, Stanford, California; and Division of Trauma and Critical Care (P.J.C., S.L.M., D.R.F., N.K.I., J.J.F.), University of Nevada School of Medicine, Las Vegas, Nevada.

Background: Laparoscopic techniques have evolved, allowing increased capabilities within most subspecialties of general surgery, but have failed to gain traction managing injured patients. We hypothesized that laparoscopy is effective in the diagnosis and treatment of penetrating abdominal injuries.

Methods: We retrospectively reviewed patients undergoing abdominal exploration following penetrating trauma at our Level 1 trauma center during a 6-year period from January 1, 2008, to December 31, 2013. Read More

Am J Emerg Med 2015 Sep 29;33(9):1188-90. Epub 2015 May 29.

Department of General Surgery, Kayseri Training and Research Hospital, Kayseri, Turkey. Electronic address:

Introduction: The study aimed to identify the presence of peritoneal penetration in management of anterior abdominal stab wound by using computed tomography (CT) tractography.

Material And Methods: Hemodynamically stabile, CT tractography-performed patients who were admitted to our emergency clinic with anterior abdominal stab wounds between the years 2012 and 2014 were included in this study, and all images were evaluated in terms of peritoneal penetration and possible intra-abdominal injury.

Results: In the study CT tractography identified necessity of laparotomy accurately in 90% of the patients, and none of the patients without peritoneal penetration needed surgical treatment in their follow-up. Read More

Eur J Trauma Emerg Surg 2015 Apr 1;41(2):161-6. Epub 2014 May 1.

Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, KwaZulu Natal, 3216, South Africa,

Introduction: Retained weapon (RW) injuries are uncommon, but there is no current consensus on the best management approach.

Methods: We reviewed our experience of 102 consecutive patients with non-missile RWs in a high-volume metropolitan trauma service managed over a 10-year period.

Results: Of the 102 patients, 95 were males (93%), 7 were females (7%), and median age was 24 (21-28) years. Read More

Am Surg 2014 Oct;80(10):984-8

LAC+USC Medical Center, Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California, USA.

In the era of nonoperative management of abdominal stab wounds, the optimal management of patients with evisceration remains unclear. Furthermore, the role of imaging in guiding management of these patients has not been defined. Patients admitted to a Level I trauma center (2005 to 2012) with evisceration after an abdominal stab wound were retrospectively identified. Read More

Am Surg 2014 Apr;80(4):403-7

Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of California at San Diego, San Diego, California, USA.

Unlike anterior stab wounds (SW), in which local exploration may direct management, posterior SW can be challenging to evaluate. Traditional triple contrast computed tomography (CT) imaging is cumbersome and technician-dependent. The present study examines the role of CT tractography as a strategy to manage select patients with back and flank SW. Read More

Rev Col Bras Cir 2014 Jan-Feb;41(1):75-9

Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.

The meeting of the Publication "Evidence Based Telemedicine - Trauma and Emergency Surgery" (TBE-CiTE), through literature review, selected three recent articles on the treatment of victims stab wounds to the abdominal wall. The first study looked at the role of computed tomography (CT) in the treatment of patients with stab wounds to the abdominal wall. The second examined the use of laparoscopy over serial physical examinations to evaluate patients in need of laparotomy. Read More

Arch Trauma Res 2013 1;2(1):21-5. Epub 2013 Jun 1.

Department of Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran.

Background: The optimal management of hemodynamically stable asymptomatic patients with anterior abdominal stab wounds (AASWs) remains controversial. The goal is to identify and treat injuries in a safe cost-effective manner. Common evaluation strategies are local wound exploration (LWE), diagnostic peritoneal lavage (DPL), serial clinical assessment (SCAs) and computed tomography (CT) imaging. Read More

J Trauma Acute Care Surg 2013 Dec;75(6):1013-7; discussion 1017-8

From the University of Tennessee Health Science Center, Memphis, Tennessee.

Background: The National Institute of Medicine's report Hospital-Based Emergency Care: At the Breaking Point highlighted the critical issue of emergency department overcrowding. At our institution, patients with anterior abdominal stab wounds (AASW) have been managed with a protocol that uses diagnostic laparoscopy (DL) after positive result on local wound exploration. Patients with negative DL result are eligible for discharge directly from the recovery room. Read More