Abstract: When primary injuries caused by penetrating violence and secondary injuries by faulty medical procedures are both present,it is important to distinguish "avoidable" from "unavoidable" secondary injuries.The primary and "unavoidable" secondary injuries rather than the secondary "avoidable" injuries should be included as evidence for assessment of the degree and grade the injuries.The basic principles to assess blood accumulation after injury have been stated in the seventy-two clause of "The Assessment Criterion of Severe Human Body Injury".However,it dose not distinguish abdominal blood accumulation caused by primary penetrating wounds from that resulted from secondary medical procedures.An amendment to the clause might be necessary.

Key words: Penetrating wounds, human abdomen, primary injury, secondary injury, medico-legal assessment