AI Article Synopsis
- The study involved 146 patients with abdominal gunshot wounds, where 72% underwent immediate surgery due to acute symptoms.
- Of the remaining 28% who showed minimal signs, 7 later required surgery, but there were no deaths or serious complications.
- The findings suggest that selective observation rather than mandatory surgery greatly reduces unnecessary operations, indicating that non-operative management can be safely applied to certain abdominal gunshot cases.
Article Abstract
This prospective study includes 146 patients with gunshot wounds of the abdomen. One hundred and five patients (72 per cent) had an acute abdomen on admission and were operated on immediately. The remaining 41 patients (28 per cent) had minimal or equivocal abdominal signs and were observed with serial clinical examinations. Seven of the observed patients needed subsequent laparotomy, but there was no mortality or serious morbidity. Had a policy of mandatory exploration for abdominal gunshot wound been applied the incidence of unnecessary or negative laparotomies would have been 27 per cent. By using a policy of selective conservatism this figure was only 5 per cent. We suggest that abdominal gunshot wounds should be assessed and managed exactly like knife wounds. Physical examination is reliable in detecting significant intra-abdominal injuries. Many carefully selected patients with abdominal gunshot wounds can safely be managed non-operatively.
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| http://dx.doi.org/10.1002/bjs.1800780230 | DOI Listing |
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