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  • Title: Negative trauma celiotomy.
    Author: Henderson VJ, Organ CH, Smith RS.
    Journal: Am Surg; 1993 Jun; 59(6):365-70. PubMed ID: 8507061.
    Abstract:
    A retrospective review of 525 consecutive exploratory celiotomies for abdominal trauma occurring between January 1987 and June 1990 in an urban trauma center was conducted. One hundred-fifteen patients sustained blunt abdominal trauma (21%), and 410 patients sustained penetrating abdominal trauma (78%). Penetrating injuries included 260 gunshot wounds and 150 stab wounds. Patients were divided into three groups: Group A (16%), no visceral injuries identified at exploration (true negative); Group B, positive operative findings at celiotomy requiring no operative repair (10%) (nontherapeutic celiotomy); and Group C (74%), injuries encountered requiring operative repair (true positive). A positive exploration rate of 90 per cent with blunt trauma is acceptable using diagnostic techniques currently available. Similarly, a positive exploration rate of 85 per cent in gunshot wounds warrants our continued use of mandatory celiotomy. A 36 per cent combined incidence of true negatives and nontherapeutic celiotomies (Group A and B) is unacceptably high. To reduce this high incidence will require improved clinical surveillance and the controlled implementation of newer diagnostic techniques.
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