Diagnostic paracentesis of the acute abdomen

Blunt abdominal injury: a review of 59 consecutive cases undergoing surgery

A consecutive series of 59 patients undergoing laparotomy as a result of blunt abdominal trauma is reported. Road-traffic accidents were the most common cause of blunt abdominal trauma and frequently produced a complex pattern of associated injuries. There were 8 deaths, giving a mortality-rate of 14 per cent. The number of associated injuries was the most important single factor influencing the mortality-rate. Delay in diagnosis occurred in 14 patients, and this may contribute to the high mortality-rate of blunt abdominal injury. A high index of suspicion, thorough and repeated clinical assessment, and willingness to resort to laparotomy are the main principles in the diagnosis of blunt abdominal injury.

Stab-wounds and other penetrating injuries of the abdomen and thorax

A series of 100 penetrating wounds of the abdomen and thorax is reviewed. Eighty-three were due to stab-wounds.

The recent increase in incidence is confirmed and the distribution throughout the day and months of the year is given.

The results and methods of treatment of thirty-six abdominal, ten thoraco-abdominal and thirty-seven thoracic wounds are given and described.

An operative approach to abdominal wounds is supported.

Conservative measures, including more frequent use of intercostal-tube drainage for pneumothorax and haemothorax, are satisfactory for the majority of chest wounds.

Cardiac wounds require urgent assessment and resuscitation with pericardiocentesis and thoracotomy.