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Penetrating trauma to abdomen is an important cause of surgical emergencies as young productive adults are involved. Patients with penetrating abdominal wound presenting with shock, peritonitis or evisceration are usually subjected to early laparotomy although a very few studies have been done to validate the criteria. AIMS & OBJECTIVES: To study the etiology, extent of organ involvement in the penetrating injury and organs most commonly involved. To assess patient, for surgical intervention and avoid negative laparotomy. To assess morbidity rate, due to different organs involved. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS: STUDY DESIGN: Prospective Clinical Study. STUDY AREA: Sri Venkateswara Medical College Tirupathi. SOURCE OF DATA: The material for the present study is collected from the patients who present to the Out Patient Department of Surgery, Sri Venkateswara Medical College with swelling in the scrotal region fulfilling the inclusion criteria. METHODS: In a prospective study of 44 consecutive patients with penetrating wounds to anterior abdomen flank or lower chest, various clinical and radiological criteria were evaluated for their accuracy in predicting the presence of significant abdominal organ injury. All the patients with peritoneal penetration, signs of generalized peritonitis, hemodynamic instability underwent exploratory laparotomy. RESULTS: Overall 30 patients (68%) had significant abdominal injury requiring repair. The criteria for significant organ injury were shock on admission, generalized peritonitis, evisceration of omentum and or bowel. Mere penetration of peritoneal cavity is a poor indicator of organ injury. Extra luminal air or free peritoneal fluid on X-ray is unreliable to predict the organ injury or to add to the management in the presence of other signs. INTERPRETATION AND CONCLUSION: Signs of hemodynamic instability generalized peritonitis are reliable criteria by themselves for early laparotomy. Peritoneal penetration by itself is a poor indicator of significant organ injury. Majority of patients with evisceration require laparotomy regardless of what has eviscerated or presence of other indications.

A P ROSPECTIVE STUDY ON PENETRATING INJURIES TO THE ABDOMEN IN S.V.R.R.G.G HOSPITAL, TIRUPATI