Interesting case this morning – abdominal stab wound

Standard ATLS/Surgical dogma is penetrating abdominal injury = absolute indication for laparotomy. However a bit of searching pubmed et al suggests a significant proportion of these type of injuries *could* be managed by expectant observation in a HDU type setting rather than by rushing to theatre. Much depends on local availability of FAST/CT/surgical experience, but it is interesting that penetrating abdominal trauma does not always sine non qua a laparotomy. There appear to be many papers on this so go google……