BACKGROUND: Management strategies for @entity2980 ( @entity2980 ) in initially asymptomatic @entity1 range from mandatory explorative laparotomy (EL) to conservative approaches with observation alone. Emergency diagnostic laparoscopy (DL) may play a potential role between these two extremes-hence lowering the rate of unnecessary laparotomies and keeping the rate of missed injuries to a minimum. @entity1 AND METHODS: At our institution mandatory EL was carried out in every @entity1 with @entity2980 until 1992. In a retrospective study the charts of 43 @entity1 with @entity2980 were reviewed in terms of initial diagnostic procedures, @entity130 , and course and length of hospital stay. Between 5/1993 and 4/1995 DL was performed in a prospective study in 15 @entity1 with suspected peritoneal penetration (PP) after @entity2980 according to a standardized diagnostic and therapeutic algorithm. RESULTS: In 17 @entity1 (40%) EL showed no PP; 15 (35%) had significant @entity130 , while 11 @entity1 with PP didn't have lacerations of intraabdominal organs, resulting in an overall rate of nontherapeutic laparotomy of 65%. Mortality was 6% (n = 3), average hospital stay 8 days. Primary DL could exclude PP in 10 out of 15 @entity1 (66%). The remaining five @entity1 (33%) showed PP: In two @entity1 with @entity2980 to the right upper quadrant, @entity130 could be excluded by DL, and in one @entity1 a low-grade @entity99 was treated laparoscopically, thus avoiding laparotomy in a total of 87% (n = 13). In two @entity1 with PP laparoscopy was converted to laparotomy: no pathological finding in one case, splenectomy for spleen laceration in the second @entity1 , resulting in a rate of nontherapeutic laparotomies of 7%. All @entity1 in this series had an uneventful course; average hospital stay was 2.4 days. CONCLUSIONS: DL offers an important diagnostic tool in excluding peritoneal penetration in @entity2980 , hence lowering the rate of unnecessary laparotomies. Given experience and skills, laparoscopy may be used therapeutically in selected cases of @entity2980 .

Emergency laparoscopy for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity99 :: ('MESH:D056486', 'Disease') :: ['liver injury'] @entity2980 :: ('MESH:D014951', 'Disease') :: ['abdominal stab wounds', 'ASW'] @entity130 :: ('MESH:D014947', 'Disease') :: ['intraabdominal injuries']
@entity2980 :: (MESH:D014951,Disease) :: ['abdominal stab wounds']
