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Visceral Injury Due to Extraperitoneal Gunshot Wounds

Visceral Injury Due to Extraperitoneal Gunshot Wounds Abstract Of 200 consecutive low-velocity abdominal gunshot wounds, 35 (17.5%) had nonpenetration of the peritoneal cavity as proved by celiotomy. Of these 35 patients, 30 (86%) did not have visceral injury while five sustained at least one visceral injury. Four of these patients sustained only minor visceral contusions not requiring surgical therapy. The fifth patient underwent exploration of an extraperitoneal bullet track with proof of peritoneal nonpenetration. The track passed beneath the deep fascia. This patient developed a jejunal perforation on the fourth hospital day and subsequently underwent celiotomy and repair. Thirty-four of our 35 patients with proven peritoneal nonpenetration did well with no surgical therapy, though penetration of the deep fascia with an intact peritoneum led to visceral injury in the case here reported. References 1. Early Care of the Injured Patient , Committee on Trauma, American College of Surgeons. Philadelphia, WB Saunders Co, 1972, p 148. 2. Shires T: Initial care of the injured patient . Trauma 10:940-948, 1970.Crossref 3. Ryzoff R, Shafton G, Herbsman H: Selective conservatism in penetrating abdominal trauma . Surgery 59:650-653, 1966. 4. Richter R, Zaki M: Selective conservative management of penetrating abdominal wounds . Ann Surg 166:238-244, 1967.Crossref 5. Bull J, Mathewson C: Exploratory laparotomy in patients with penetrating wounds of the abdomen . Am J Surg 116:223-228, 1968.Crossref 6. Wilson H, Sherman R: Civilian penetrating wounds of the abdomen . Ann Surg 153:639-649, 1961.Crossref 7. Stein A, Lissoos I: Selective management of penetrating wounds of the abdomen . J Trauma 8:1014-1025, 1968.Crossref 8. Maynard A, Oropeza G: Mandatory operation for penetrating wounds of the abdomen . Am J Surg 115:307-312, 1968.Crossref 9. Sako Y, et al: A survey of evacuation, resuscitation and mortality in a forward surgical hospital . Surgery 37:602-611, 1955. 10. Demuth W: Bullet velocity as applied to military rifle wounding capacity . J Trauma 9:27-38, 1969.Crossref 11. Demuth W: Bullet velocity and design as determinants of wounding capability: An experimental study . J Trauma 6:222-232, 1966.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Visceral Injury Due to Extraperitoneal Gunshot Wounds

Archives of Surgery , Volume 108 (6) – Jun 1, 1974

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Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1974.01350300095022
Publisher site
See Article on Publisher Site

Abstract

Abstract Of 200 consecutive low-velocity abdominal gunshot wounds, 35 (17.5%) had nonpenetration of the peritoneal cavity as proved by celiotomy. Of these 35 patients, 30 (86%) did not have visceral injury while five sustained at least one visceral injury. Four of these patients sustained only minor visceral contusions not requiring surgical therapy. The fifth patient underwent exploration of an extraperitoneal bullet track with proof of peritoneal nonpenetration. The track passed beneath the deep fascia. This patient developed a jejunal perforation on the fourth hospital day and subsequently underwent celiotomy and repair. Thirty-four of our 35 patients with proven peritoneal nonpenetration did well with no surgical therapy, though penetration of the deep fascia with an intact peritoneum led to visceral injury in the case here reported. References 1. Early Care of the Injured Patient , Committee on Trauma, American College of Surgeons. Philadelphia, WB Saunders Co, 1972, p 148. 2. Shires T: Initial care of the injured patient . Trauma 10:940-948, 1970.Crossref 3. Ryzoff R, Shafton G, Herbsman H: Selective conservatism in penetrating abdominal trauma . Surgery 59:650-653, 1966. 4. Richter R, Zaki M: Selective conservative management of penetrating abdominal wounds . Ann Surg 166:238-244, 1967.Crossref 5. Bull J, Mathewson C: Exploratory laparotomy in patients with penetrating wounds of the abdomen . Am J Surg 116:223-228, 1968.Crossref 6. Wilson H, Sherman R: Civilian penetrating wounds of the abdomen . Ann Surg 153:639-649, 1961.Crossref 7. Stein A, Lissoos I: Selective management of penetrating wounds of the abdomen . J Trauma 8:1014-1025, 1968.Crossref 8. Maynard A, Oropeza G: Mandatory operation for penetrating wounds of the abdomen . Am J Surg 115:307-312, 1968.Crossref 9. Sako Y, et al: A survey of evacuation, resuscitation and mortality in a forward surgical hospital . Surgery 37:602-611, 1955. 10. Demuth W: Bullet velocity as applied to military rifle wounding capacity . J Trauma 9:27-38, 1969.Crossref 11. Demuth W: Bullet velocity and design as determinants of wounding capability: An experimental study . J Trauma 6:222-232, 1966.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jun 1, 1974

References