SURGICAL MANAGEMENT AND IMMEDIATE TREATMENT OF PENETRATING ABDOMINAL TRAUMA

Penetrating abdominal trauma is associated with high morbidity and mortality rates and poses decision-making challenges in emergency care. The objective of this study was to review and synthesize the scientific evidence regarding surgical approaches, diagnostic workup, and immediate management of these injuries. This is a narrative literature review conducted in the PubMed database, supplemented by international consensus statements from the World Society of Emergency Surgery (WSES). Hemodynamic stability is established as the primary therapeutic dividing line: unstable patients or those with refractory hemorrhagic shock require immediate exploratory laparotomy or damage control surgery (DCS), whereas stable patients benefit from bedside triage using the eFAST protocol, computed tomography (CT), and selective non-operative management (SNOM) or laparoscopic approaches. The success of conservative or minimally invasive approaches is based on rigorous patient selection and continuous clinical and laboratory monitoring for early identification of complications. It is concluded that the contemporary management of penetrating abdominal trauma requires individualized, management-dependent approaches, combining definitive surgical interventions with a reduction in non-therapeutic laparotomies.