Abdominal gunshot wounds. An urban trauma center's experience with 300 consecutive patients.

Abstract:

:From July 1983 through December 1987, 300 consecutive patients with penetrating gunshot wounds of the abdomen causing visceral or vascular injuries were treated. Resuscitative thoracotomy was required in 20 patients (6.6%), and only two survived. The most commonly injured organs were the small bowel (60%), colon (41.6%), liver (29.3%), vascular structures (24.6%), stomach (17.3%), and kidney (17.0%). The overall survival rate for the series was 88.3%; however, if only the 226 patients without vascular injuries are considered, the survival rate was 97.3%. In the 35 patients who died, the blood pressure on admission was 51 mmHg, 18 required a resuscitative thoracotomy, four visceral or vascular injuries were present, and the median blood replacement was 18 units. The cause of death was perioperative shock in 30 patients (85.7%), whereas five patients (14.3%) died of sepsis and multiple organ failure. The most common postoperative complication in survivors and patients who died later in the study was an intra-abdominal abscess (3.0%). Rapid conservative operative techniques for civilian gunshot wounds leads to few postoperative complications and an excellent survival rate, especially if vascular injuries are not present.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Feliciano DV,Burch JM,Spjut-Patrinely V,Mattox KL,Jordan GL Jr

doi

10.1097/00000658-198809000-00014

subject

Has Abstract

pub_date

1988-09-01 00:00:00

pages

362-70

issue

3

eissn

0003-4932

issn

1528-1140

journal_volume

208

pub_type

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