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Case Report
Experiencing cardiac arrest during surgical exploration in hemodynamically stable patients with multiple stab wounds, including lower extremity in Korea: a case report
Jung Rae Cho, Dae Sung Ma
J Trauma Inj. 2024;37(2):166-169.   Published online June 14, 2024
DOI: https://doi.org/10.20408/jti.2024.0025
  • 4,079 View
  • 63 Download
AbstractAbstract PDF
Stab wounds, particularly those affecting multiple body regions, present considerable challenges in trauma care. This report describes a case of sustained self-inflicted stab injuries to the abdomen and thighs of a 23-year-old male patient. Although the patient’s vital signs were stable and bleeding was minimal from thigh wounds without overt signs of vascular injury, the patient experienced a sudden, profound hemorrhage from the right thigh, leading to cardiac arrest. Successful resuscitation was followed by surgical repair of a right superficial femoral arterial injury accompanying a resuscitative endovascular balloon of the aorta. Subsequent lower extremity computed tomography angiography revealed no additional vascular abnormalities. The patient was discharged in stable condition on the 12th postoperative day. This case underscores the unpredictability of stab wound trajectories and the potential for hidden vascular injuries, even in the absence of immediate life-threatening signs. It also emphasizes the critical role of advanced imaging modalities, such as computed tomography angiography, in identifying concealed injuries, and the importance of strategic intraoperative techniques, including resuscitative endovascular balloon occlusion of the aorta, in achieving favorable patient outcomes.
Summary
Review Article
Biomechanics of stabbing knife attack for trauma surgeons in Korea: a narrative review
Kun Hwang, Chan Yong Park
J Trauma Inj. 2024;37(1):1-5.   Published online January 15, 2024
DOI: https://doi.org/10.20408/jti.2023.0057
  • 13,516 View
  • 202 Download
  • 2 Web of Science
  • 3 Citations
AbstractAbstract PDF
The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.
Summary

Citations

Citations to this article as recorded by  
  • Exploring the effects of silica particles size on soft body armour panels for stab resistance application in advanced protective textiles
    Shankar Lal Sharma, Lalit Jajpura, Mukesh Bajya
    Journal of Composite Materials.2026;[Epub]     CrossRef
  • A drop test device to study the variability of residual marks associated with stabbing attacks
    Ignasi Galtés, Silvia García-Vilana, David Sánchez-Molina
    Forensic Sciences Research.2026; 11(1): tfsr20240266.     CrossRef
  • Experimental investigation on dynamic stab resistance of high-performance multi-layer textile materials
    Mulat Alubel Abtew, François Boussu, Irina Cristian, Bekinew Kitaw Dejene
    Defence Technology.2025; 47: 1.     CrossRef
Original Article
Indications for an Immediate Laparotomy in Patients with Abdominal Stab Wounds
Hyeong Ju Kim, Seong Youn Hwang, Young Cheol Choi
J Korean Soc Traumatol. 2007;20(2):106-114.
  • 2,975 View
  • 15 Download
AbstractAbstract PDF
PURPOSE
There is little controversy that a classic indication such as hemodynamic instability or any sign of peritoneal irritation requires an immediate laparotomy in the management of abdominal stab wounds. However, omental herniation or bowel evisceration as an indication for an immediate laparotomy is controversial. The purpose of this study was to evaluate the significance of these factors as indications for an immediate laparotomy.
METHODS
The medical records of 98 consecutive abdominal stab wounds patients admitted to the Emergency Center of Masan Samsung Hospital from January 2000 to December 2006 were carefully examined retrospectively. Using multivariate logistic regression analysis, thirty-nine factors, including the classic indication and intraabdominal organ evisceration, were evaluated and were found to be associated with a need for a laparotomy. Also, the classic indication was compared with a new indication consisting of components of the classic indication and intra-abdominal organ evisceration by constructing a contingency table according to the need for a laparotomy.
RESULTS
Multivariate logistic regression analysis revealed any sign of peritoneal irritation, base deficit, and age to be significant factors associated with the need for a laparotomy (p<0.05). The sensitivity, specificity, and accuracy rates of the classic indication were 98.6%, 72.0%, and 91.8%, respectively, and those of the new indication were 93.2%, 84.0%, and 90.8%, respectively. The differences in those rates between the above two indications were not significant.
CONCLUSION
Intra-abdominal organ evisceration was not a significant factor for an immediate laparotomy. Moreover, the new indication including intra-abdominal organ evisceration was not superior to the classic indication. Therefore, in the management of abdominal stab wounds, the authors suggest that an immediate laparotomy should be performed on patients with hemodynamic instability or with any sign of peritoneal irritation.
Summary
J Trauma Inj : Journal of Trauma and Injury
© The Korean Society of Traumatology.
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