A 25-year-old man sustains a stab wound to the left upper quadrant. He is hemodynamically stable with no peritonism. Local wound exploration confirms fascial penetration. What is the most appropriate next step?
- A Discharge with wound care
- B CT abdomen with intravenous contrast ✓
- C Mandatory exploratory laparotomy
- D Diagnostic peritoneal lavage
Correct answer: B. CT abdomen with intravenous contrast
Explanation
In a stable patient with a penetrating anterior abdominal wound and confirmed fascial penetration but no peritonism, triple-contrast CT is the preferred investigation to evaluate for intra-abdominal injury. Mandatory laparotomy is indicated only for hemodynamic instability, peritonism, or evisceration. DPL has largely been replaced by CT in stable patients.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.