Outcome of gunshot abdominal injuries

Bonko, Neville Mengjo; Badawy, Maryam; Nchifor, Keafon; Mumba, Mina; Omboga, Leon; Mugo, Robert; Kimani, Sandra; Kwamboka, Catherine; Moraa, Moce; Dimala, Akem; Githaiga, Joseph

doi:10.4314/aas.v17i1.8

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…It has been well documented that the time from injury to surgery is an effective factor in the development or increase in the depth of shock. [ 16 ] In our study, it was observed that the time from injury to surgery had a significant effect on mortality (P<0.001) but had no significant effect on the development of complications.…”

Section: Discussionmentioning

confidence: 61%

Risk factors for mortality and morbidity in Syrian refugee children with penetrating abdominal firearm injuries: an 1-year experience

Tuşat

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Despite improvements in technology and surgical techniques, abdominal injuries caused by firearms in children are traumatic with high complication rates and mortality. In this study, factors affecting mortality and complications in penetrating abdominal firearm injuries caused by high-velocity bullets and shrapnel in children as a result of the civil war in Syria were evaluated. METHODS:This study was conducted as a case series with 53 patients admitted to Kilis State Hospital with penetrating abdominal firearm injuries between January 2016 and February 2017. Patients aged between 6 months and 17 years who suffered penetrating abdominal firearm injuries (PAFI) as a result of the civil war in Syria in the state hospital in Kilis Türkiye border province with Syria and were transferred to our hospital and operated on were included in the evaluation. Patients' sociodemographic information, time to surgery, number of abdominal organs injured, type of firearm causing injury, presence of large vessel injury and extremity injury, presence of thoracic injury requiring thoracotomy in addition to laparotomy, colostomy, penetrating abdominal trauma index, pediatric trauma score (PTS), and shock status were evaluated. RESULTS:In our study, it was found that a high penetrating abdominal trauma index significantly increased complication rates and mortality (P<0.001 and P=0.002, respectively). In addition, it was found that lower PTSs significantly increased the development of complications and mortality (P=0.001 and P<0.001, respectively). Mortality was not observed in any of the patients with a PTS>8, whereas mortality was observed in 27.3% of patients with a PTS≤8, and this result was statistically significant (P=0.003). Shock significantly increased mortality, and no patient who was not in shock died (P<0.001). In our study, it was determined that the increase in the number of injured intra-abdominal organs had a significant effect on both complications and mortality (P<0.001 and P=0.002, respectively). CONCLUSION:The penetrating abdominal trauma index and PTS were found to be effective in predicting mortality and morbidity in pediatric patients with PAFI. It is crucial in this patient group to provide appropriate transport after the first intervention is done rapidly and effectively in conflict zones.

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Section: Discussionmentioning

confidence: 61%

Risk factors for mortality and morbidity in Syrian refugee children with penetrating abdominal firearm injuries: an 1-year experience

Tuşat

2023

Ulus Travma Acil Cerrahi Derg

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“…However, the variability in terms of how dangerous they provoke complications exist. For instance Gunshot as one of the mechanisms of penetrating abdominal injury is associated with many complications [1]. If the bullet of high velocity and large mass was used, many complications develop because of the damage of multiple abdominal organs.…”

Section: Mechanisms Of Abdominal Trauma Related Risk Factorsmentioning

confidence: 99%

“…Moreover, other authors have devised criteria of complication in surgical practice; in certain book of neurosurgery complication has been regarded as an occurrence which fulfills three criteria namely, unwanted, unplanned and does not commonly occur. Management of abdominal trauma is complex and remains a problematic in surgical practice due to notable occurrence of numerous complications [1]. Failure to recognize and treat these complications earlier increases the mortality and morbidity.…”

Section: Introductionmentioning

confidence: 99%

Complications and Avoidance of the Complications Associated with Management of Abdominal Trauma

Nzayikorera¹

2023

Abdominal Trauma - New Solutions to Old Problems

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Despite decades of dramatic advance in treatment and prevention of trauma, globally trauma continues to be a major public health problem. More than 5 million individuals perish every year as a consequence of injuries. This is responsible for about 9% of the world’s deaths, approximately 1.7 times the number of mortalities that result from HIV/AIDS, tuberculosis and malaria combined. Abdominal trauma continues to be the leading cause of mortality and morbidity in all age groups. A comprehensive management of traumatic abdominal patient with various approaches is of proven value in terms of mitigating the burden associated with abdominal trauma. However, all available approaches used to manage traumatic abdominal patient are potentially associated with development of various complications. Practical to mitigate these complications, various measures should be considered all the time while managing any traumatic abdominal patient. The goal of this chapter is to describe systematic approaches for avoiding the complications associated with management of abdominal trauma. Moreover, it describes the common and some rare complications associated with the management of traumatic abdominal patient.

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Outcomes of selective non-operative management in adults with abdominal gunshot wounds: A systematic review and meta-analysis

Liu,

Fang,

Bai

et al. 2023

International Journal of Surgery

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Background and Aims: Abdominal gunshot wounds (GSWs), a clinically devastating injury, can result in a variety of severe and lethal complications. Traditionally, exploratory laparotomy is the first-line approach for the management of abdominal GSWs, but associated with a considerable amount of unnecessary surgeries. At present, selective non-operative management (SNOM) of abdominal GSWs is becoming an effective and well-recognized approach, but remains widely disputed since many surgeons are skeptical about the validity of SNOM in clinical practice. This meta-analysis aims to estimate the outcomes of SNOM and immediate laparotomy in patients with GSWs by collecting the currently available evidence. Methods: The PubMed, EMBASE, and Cochrane Library databases were searched. A random-effects model was employed. Pooled proportion with 95% confidence intervals (CIs) was calculated. Heterogeneity was evaluated using the Cochran’s Q test and I2 statistics. Results: Overall, 53 studies involving 60,291 participants were included. The pooled proportions of SNOM and SNOM failure were 27.0% (95%CI=24.0%-30.0%) and 10.0% (95%CI=7.0%-13.0%), respectively. The pooled mortality after SNOM and SNOM failure were 0.0% (95%CI=0.0%-1.0%) and 0.0% (95%CI=0.0%-0.0%), respectively. The pooled proportions of immediate laparotomy and unnecessary immediate laparotomy were 73.0% (95%CI=70.0%-76.0%) and 10.0% (95%CI=8.0%-13.0%), respectively. The pooled mortality after immediate laparotomy and unnecessary immediate laparotomy were 10.0% (95%CI=8.0%-13.0%) and 0.0% (95%CI=0.0%-1.0%), respectively. Heterogeneity was statistically significant in nearly all meta-analyses. Conclusion: Immediate laparotomy is still the mainstay approach for the management of abdominal GSWs. Approximately one third of patients with abdominal GSWs undergo SNOM. SNOM failure is not frequent and its related mortality is also rare.

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Outcome of gunshot abdominal injuries

Cited by 3 publications

References 15 publications

Risk factors for mortality and morbidity in Syrian refugee children with penetrating abdominal firearm injuries: an 1-year experience

Risk factors for mortality and morbidity in Syrian refugee children with penetrating abdominal firearm injuries: an 1-year experience

Complications and Avoidance of the Complications Associated with Management of Abdominal Trauma

Outcomes of selective non-operative management in adults with abdominal gunshot wounds: A systematic review and meta-analysis

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