الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Before World War 1, penetrating abdominal injuries have been managed by operative exploration irrespective of the hemodynamic condition of the patient. The majority of clinicians would choose the surgical option for the management of patients with hemodynamic instability. The high non-therapeutic/negative laparotomy rate and associated morbidity after EL for abdominal penetrating injuries led to the current of NOM strategy (conservative management); selective NOM of PAT is well studied and practiced worldwide. It included serial clinical examinations of the patient, preferably by the same clinician, and laboratory testing over a minimum of 24 h. The standard management of PAT was for many years mandatory laparotomy. A greater understanding of mechanisms of injury, outcomes from surgery, improved imaging and interventional radiology has led to more conservative operative strategies being adopted (Wortman et al., 2018). In our study, we use the laparoscopy in the treatment and diagnosis of PAT cases. We collected all cases from our department of surgery (Trauma unit), 33 cases were studied. We used laparoscopy as surgical intervention for all cases, after clinical evaluation and necessary investigations were done. All cases had consent either from patient or his relatives. We selected, patients with PAT (Anterior trauma) through group of inclusion criteria most important are stable patient with normal vital data and Presence of expert laparoscopic surgeon. We excluded Patients with contraindication to laparoscopy (haemodynamically unstable patients, coagulopathies), Patients with a clear indication for immediate laparotomy such as frank peritonitis, hemorrhagic shock or eviscerationPatients with known or obvious intra-abdominal injury. Patients with posterior PAT with high likelihood of retroperitoneal injuries. Patients with other associated serious injuries as brain or spinal cord injuries. And Limited laparoscopic expertise. All cases receive general anesthesia, we registered all complications and outcomes. As regard to equipment, we used laparoscope of our department and all instrument we needed.