Penetrating Abdominal Wounds

Abstract

ESCALATION of civilian violence in our nation (Time, March 23, 1981, pp 16-21) continues to make physical trauma the leading cause of death in persons up to 38 years of age.²Life-threatening penetrating wounds to our President, the Pope, and countless innocent citizens provide the rationale to discuss the management of such injuries in a journal representing multiple specialty interests. During the ensuing decade since the review by Freeark,¹considerable attention has been directed toward indications for celiotomy after a penetrating abdominal wound. This report summarizes these recent trends. Historical Notes Nonoperative management of penetrating abdominal wounds prevailed from the first recordings of medical history until the late 19th century. J. Marion Sims of Brooklyn, who is considered the first advocate of celiotomy for penetrating wounds, espoused this concept before the New York Academy of Medicine in 1881. Later in the same year, President James A. Garfield died of