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Debate continues about optimal management of anterior abdominal stab wounds. In a 2-year prospective trial of 359 patients (age, ≥16 years) with anterior abdominal stab wounds at 11 trauma centers in the U.S., those who had shock, evisceration of omentum or bowel, or peritonitis underwent immediate laparotomy, and patients without those findings were managed according to individual surgeon’s or institution’s protocols. Patients with back, flank, or thoracoabdominal wounds and those who were pregnant were excluded.
Immediate laparotomy was performed in 81 (23%) patients and was therapeutic (surgical intervention was necessary) in 84%. Among the remaining 278 patients, negative test findings were the basis for emergency department discharge in…