Nonoperative Management of Gunshot Injury of Abdomen in A 10-Year-Old Boy

Karabulut, Ramazan; Türkyılmaz, Zafer; Sönmez, Kaan; Başaklar, A. Can

doi:10.1007/s12262-012-0563-z

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2013

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“…Surgical exploration is still considered as the standard of care for abdominal GSW 4 5. However, in a select group of patients, a mandatory laparotomy approach has been changed to a non-operative strategy over the last few years 2.…”

Section: Discussionmentioning

confidence: 99%

Conservative management of an abdominal gunshot injury with a peritoneal breach: wisdom or absurdity?

Khan¹,

Pardhan²,

Bawa³

et al. 2013

BMJ Case Reports

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SUMMARYSurgical exploration has been the standard of care for abdominal gunshot injuries. The authors report a case of a 28-year-old man who sustained a transabdominal gunshot injury, which entered the anterior abdominal wall and exited adjacent to the T12 vertebra posteriorly with a tangential trajectory. On presentation, the patient was haemodynamically stable with no peritoneal signs. Based on trajectory of the bullet, intra-abdominal injury was suspected. Therefore a CT scan abdomen with intravenous and rectal contrast was performed. The CT scan revealed no extravasation of the rectal contrast but showed free air specks behind the descending colon. Delayed renal images of the left ureter were also normal. Based on the clinical findings, the patient was managed nonoperatively with nothing per oral, intravenous antibiotics and frequent abdominal assessments. He made an uneventful recovery without necessitating laparotomy. BACKGROUND

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Section: Discussionmentioning

confidence: 99%