Selective nonoperative management of pediatric penetrating abdominal trauma

Penetrating abdominal trauma from gunshot or stab wounds accounts for just 10% of all abdominal injuries in children. Exploratory laparotomy has been the surgical dictum for the evaluation penetrating abdominal injuries; however, accumulating data in the adult and pediatric literature indicate that selective nonoperative management may be safely considered in hemodynamically stable children after careful clinical examination and appropriate radiographic evaluation. We describe 2 children with penetrating abdominal injury who were managed successfully nonoperatively and briefly review the literature on this approach in children.