Selective nonoperative management for patients with penetrating abdominal stab wounds and with COVID-19 (clinical case)

Abstract

   Introduction. In modern state, the number of victims with penetrating abdominal wounds remains at the level of 5 to 22 % according to various sources [1, 2]. However, not all of them are accompanied by injuries to internal organs, only 75,9–87,7 % of them require invasive surgical treatment [3, 4]. Currently, in the clinical practice of large hospital centers, the leading trend has become the reducing the level of surgical aggression and the correct choice of patient management tactics.
   Purpose. Improving the effectiveness of the treatment of hemodynamically stable patients with penetrating stab wounds with diagnosed coronavirus pneumonia through the use of a selective approach and nonoperative management.

   Methods. A clinical case of the use of selective non operative management in one patient with penetrating stab abdominal wounds in combination with pneumonia of viral etiology is considered.
   Results. The possibility of effective treatment of a patient according to the protocol of nonoperative management with concomitant lung lesions in a new coronavirus infection has been demonstrated.
   Conclusion. A selected approach and nonoperative management in hemodynamically stable patients with penetrating abdominal injuries are also applicable if the patient has concomitant coronavirus pneumonia and allows avoiding "unnecessary" extensive surgical interventions, thereby reducing the risk of postoperative complications against the background of infiltrative changes in the lungs.