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• W3208170232 abstract "Trauma centres vary in their approaches to managing stable patients with anterior abdominal stab wounds (AASWs), with no approach yet proven superior. We sought to evaluate the performance of screening laparoscopy (i.e., parietal peritoneal penetration or not) in determining which patients should undergo laparotomy.We conducted a retrospective case series study, including all patients with an AASW who presented to U.C. Davis Medical Center from January 2003 through March 2009. We collected data from medical records using a standardised, pre-tested instrument. Among laparoscopically screened cases, we determined the test characteristics of peritoneal penetration for detecting intra-abdominal injury. We sub-classified injuries as “requiring treatment” (e.g., full-thickness enterotomy or active haemorrhage) or not.Of 358 patients with AASWs, 163 underwent screening laparoscopy. Seventy-eight of the 163 (48%) had no peritoneal penetration and six (4%) had peritoneal penetration but a low-risk wound; none of these 84 underwent laparotomy nor had a missed injury. Of 79 patients with peritoneal penetration who underwent laparotomy, 61 had an intra-abdominal injury, of whom 42 were treated intraoperatively. Among these 42, 30 had an injury “requiring treatment.” The PPV of peritoneal penetration for an injury requiring treatment was 38% (30/79) (95% CI 27–50%), NPV 100% (84/84) (95% CI 95–100%), sensitivity 100% (30/30) (95% CI 88–100%), and specificity 63% (84/133) (95% CI 54–71%). The negative and positive likelihood ratios were 0 (95% CI 0–0.4) and 2.7 (95% CI 2.2–3.4), respectively.Screening laparoscopic evaluation of the parietal peritoneum results in a negligible rate of missed injury and an approximately 40% rate of finding an injury requiring treatment." @default.
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• W3208170232 date "2022-08-01" @default.
• W3208170232 modified "2023-10-09" @default.
• W3208170232 title "Utilidad de la ecografía torácica en la valoración y seguimiento del niño grave por síndrome inflamatorio multisistémico pediátrico: estudio prospectivo observacional" @default.
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• W3208170232 doi "https://doi.org/10.1016/j.medin.2021.08.008" @default.
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