Therapeutic approachs to the abdominal gunshot wounds

Abstract

Purpose: Although conservative management is applied to most of the patients with blunt and stab wound abdominal injuries, patients with abdominal gunshot injury are treated by emergent surgical exploration. However, nonoperative conservative management has been performed for such injuries in recent years. In this study, we aimed to analyze our experience in patients with abdominal gunshot injury with regard to treatment modalities and their outcomes.

Materials and Methods: Nineteen patients with abdominal gunshot injury were analyzed by using a prospective database between December 2008 and July 2011. Patients were evaluated with parameters including age, gender, type of firearms, localization of injuries, associated injuries, indication and timing of surgical treatment, intraoperative findings, type of the operation, Penetrating Abdominal Trauma Index, length of hospitalization stay, rates of mortality and morbidity.

Results: There were 15 male (79%) and 4 female (21%) patients, mean age was 31.3 years. Three patients (15.8%) were operated immediately because of hemodynamic instability. Seven patients (36.8%) were operated with in the 2nd to 24th hours due to peritonitis signs. There were one negative and one non-therapeutic laparotomy in the operated patients. Other 9 patients (47.4%) were managed nonoperatively without any complication. There was one dead patient (5.3%) who was operated immediately because of thoracal and abdominal gunshot injuries.

Conclusion: Nonoperative management is possible for patients with abdominal gunshot injury if they are hemodynamically stable and they do not have signs of peritonitis.