Contemporary management of abdominal stab wound with retained knife – A practical guide

The incidence of penetrating abdominal trauma (PAT) varies widely depending on geography. In New Zealand, where the proportion of major trauma secondary to penetrating injury is approximately 5%, the overall volume of stab wounds (SW) is relatively low compared with countries such as the United States of America and South Africa. There is no current national guideline for the management of abdominal SW and thus the treatment is largely clinician dependent. The specific clinical scenario of abdominal SW with an associated retained knife is even rarer, but is challenging to manage. Most literature on the topic consists of anecdotal case reports. Very few centres will have accumulated sufficient experience to formulate management algorithms for this particular scenario. This article focuses on the general principles and management strategies for this specific injury. This is based on the author’s personal published and institutional experience over a decade from a high-volume major trauma centre in South Africa. It is aimed at medical students and qualified clinicians who may encounter such injury in the emergency department.