Prise en charge des traumatismes pénétrants de l’abdomen : des spécificités à connaître

Contribution of imaging in the initial management of ballistic trauma

“…This study demonstrated that 96% of the cases of these ballistic traumas were civilians and in particular young men. These findings corroborate those in the literature where studies have reported that injuries by bullets currently more and more often concern young people in ''politically unstable'' countries or urban violence in large cities due to banditry or terrorism [4,5].…”

“…Firearms are responsible for two types of wounds: tunnel of attrition where the tissue is directly destroyed by the passage of the projectile and a peripheral zone where the tissue damage is caused by the transmission of the energy dissipated by the projectile [5]. This temporary zone of cavitation is more marked in case of tipping, fragmentation or deformation of the projectile and may amount to 25 times the calibre of the bullet [5].…”

“…This temporary zone of cavitation is more marked in case of tipping, fragmentation or deformation of the projectile and may amount to 25 times the calibre of the bullet [5]. All of these lesions depend on the ballistic properties of the bullet (energy, type, stability) and the medium crossed [1].…”

“…Therefore, not very dense and elastic organs such as the lungs and hollow organs easily absorb the energy transmitted and are relatively tolerant as regards bullet wounds while the solid organs are less elastic and more exposed to cavitation phenomena. However, bone is without any elasticity [1,5]. It breaks and splits up with the generation of multiple slivers and destabilizes the bullet, creating a change, a rotation or fragmentation of the latter with the creation of secondary lesions [5].…”

“…However, bone is without any elasticity [1,5]. It breaks and splits up with the generation of multiple slivers and destabilizes the bullet, creating a change, a rotation or fragmentation of the latter with the creation of secondary lesions [5]. Ballistic traumas require special care that depends on the topography of the projectile, the clinical state and the technical and logistic possibilities of the place of care.…”