What will be the initial management in a hemodynamically stable patient with an anterior abdominal stab injury presenting with a tag of omentum protruding through the abdominal wall near the umbilicus and showing no signs of peritonitis?: (A) FAST, (B) CECT Abdomen, (C) Exploratory Laparotomy, (D) Local Wound Exploration and Suturing
Answer is B. emodynamically Stable patients with omental protrusion should be investigated thoroughly first with an abdomino-pelvic contrast enhanced CT scan, before proceeding to surgery. Exploratory Laparotomy is not an absolute indication for this case. Ref: Reference: Trauma: A Comprehensive Emergency Medicine Approach By Eric Legome, Page222; Imaging & Intevention in Abdominal trauma (springer) 2004, Page 394; Emergency management of Trauma Patient: Cases, Algorihm, Evidence (Lippincott- Williams) 2006, Page 97; Imaging and intervention in abdominal trauma R. F. Dondelinger, Gina M. Allen, Page 392.