Stab wounds to the abdomen occur when a sharp object penetrates the abdominal cavity. Knife blades and projectile fragments are often associated with penetrating wounds. Because of the number of other organs within the abdominal area, the potential for injury to these can lead to multiple complications. Injuries will vary depending upon the length and size of the weapon and the force or angle of penetration.
Liver and spleen
According to "Sheehy's Manual of Emergency Care," the liver is the largest solid organ in the body and is injured in about 19 percent of penetrating abdominal cases. The liver is frequently injured because of its anterior location and because it is relatively unprotected. The spleen is also one of the organs that can be injured with a stab wound to the abdomen. The spleen in located in the left upper quadrant of the abdomen. Both the liver and spleen are vascular organs that can cause significant bleeding.
Intestinal Injury
The small and large bowel fill the majority of the abdominal cavity. If the intestines are injured from the penetration, bowel contents will spill into the abdominal cavity and increase the potential for severe infections
Respiratory Complications
The diaphragm, which is the primary muscle for respiration, can be injured from a stab wound through the abdomen. Injury to the diaphragm is injured can result in severe breathing problems.
Additonal Organs Injured
Other organs that could potentially be injured include the bladder, kidneys and stomach. Surgical repair may be necessary for injuries to any of the major organs in the abdomen.
Major Abdominal Vessels
Major blood vessels--the aorta, inferior vena cava and mesenteric veins--are also located within the abdominal cavity. Injury to these vessels can result in serious bleeding and death if the bleeding is not controlled immediately.
Diagnosis and Outcomes
Different tests may be required to determine what internal injuries have occurred from the stab wound. A computed tomography, or CT, scan may be performed. Testing by means of a portable bedside ultrasound machine--known as a FAST (focused assessment sonography for trauma exam)--may be done. Patients who have sustained stab wounds to the abdomen are at risk for serious bleeding and infection. Stab wounds occur nearly 3 times more often than gunshot wounds and have a very low mortality rate,1 to 2 percent.
References
- "Sheehy's Manual of Emergency Care"; Emergency Nurses Association; 2006
- "Critical Care Nursing Quarterly"; Penetrating and Blunt Abdominal Trauma; Kristine L. Eckert; January/March 2005
- "Rosen's Emergency Medicine: Concepts and Clinical Practice"; John A. Marx, Robert S. Hockberger, M.D., Ron M. Wallis, M.D.; 2002
- "EMC of North America"; Advances in Abdominal Trauma; Jennifer Isenhour, John Marx; 2007
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