The role of computed tomography in selective management of gunshot wounds to the abdomen and flank

Enrique Ginzburg, Eddy H. Carrillo, Tammy Kopelman, Mark G. McKenney, Orlando C. Kirton, David V Shatz, Danny Sleeman, Larry C. Martin

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

Objective: To determine whether computed tomography (CT) is an accurate diagnostic modality for the triage of hemodynamically stable patients with gunshot wounds of the abdomen and flank. Methods: A chart review of 83 trauma patients for whom abdominal CT was used as initial screening. Results: In 53 patients, CT revealed no evidence of peritoneal penetration, and in 15 patients, there was evidence of either peritoneal penetration or liver injury. There were no false results in these patients. Among 15 patients with questionable peritoneal penetration, cavitary endoscopy was performed in 11 and exploratory laparotomy was performed in 3, and 1 patient was initially observed and subsequently underwent exploratory surgery for a missed colonic injury. Conclusion: In selected centers and in hemodynamically stable patients with abdominal and flank gunshot wounds, abdominal CT can be an effective and safe initial screening modality to document the presence or absence of peritoneal penetration and to manage nonoperatively stable patients with liver injuries. If there is any question of peritoneal penetration, cavitary endoscopy should be part of the protocol of nonoperative management.

Original languageEnglish (US)
Pages (from-to)1005-1009
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume45
Issue number6
DOIs
StatePublished - Dec 1998
Externally publishedYes

Keywords

  • Abdominal gunshot wounds
  • Cavitary endoscopy
  • Computed tomography
  • Penetrating trauma

ASJC Scopus subject areas

  • Surgery

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