Indications for operation in abdominal trauma.

I N general, traumatic wound therapy in civilians foIIows military practice. After WorId War II it was inevitabIe that the war time management of abdominal wounds should carry over into the peace time emergency rooms and operating theaters. The miIitary practice of routineIy performing earIy expIoration was based on the almost uniformly fatal outcome of non-operative treatment of patients with intraperitonea1 injuries [I]. The reduction of this rate was directIy proportional to the reduction in the time interval between occurrence of the wound and repair [r,2]. Bowers [j] epitomized this poIicy of earIy surgery, “With penetrating abdomina1 wounds . . . the question is not if we shouId operate but when.” Routine earIy operation in abdomina1 trauma was carried out in our hospita1 in the early 1930’s. In the period from rg52 to 1954, 133 patients with abdominal trauma were treated. In 75 per cent of these the injuries were of the penetrating type. (TabIe I.) Spreng [4], in an un-