title: Transaxial gunshot injuries.
abstract: OBJECTIVE
  To define the clinical characteristics of gunshot injuries across the truncal midline (transaxial injuries).
  
  
  METHODS
  A retrospective case-control study
  
  
  METHODS
  Analysis of a consecutive series of 223 patients with gunshot injuries to the torso treated at one trauma center. Sixty-three patients with transaxial injuries were compared to 148 patients with unilateral bullet trajectories.
  
  
  RESULTS
  The incidence of cardiac (8%), vascular (17%), and spinal (29%) injuries and the mortality rate (29%) were significantly higher among the 63 patients with transaxial injuries compared with 148 patients with unilateral injuries. Initial operative access to the wrong visceral cavity (10%), missed injuries (14%), and early reoperations (19%) were also more common in the transaxial group.
  
  
  CONCLUSIONS
  A transaxial bullet trajectory identifies a distinct injury pattern associated with a high incidence of major visceral damage, intraoperative misadventures, and very high mortality.
authors.affiliation: Department of Surgery, Chaim Sheba Medical Center, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Hirshberg
authors.forename: J
authors.initials: J
authors.lastname: Or
authors.forename: M
authors.initials: M
authors.lastname: Stein
authors.forename: R
authors.initials: R
authors.lastname: Walden
mesh_terms: D000007:Abdominal Injuries / Q000401:mortality / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000401:mortality / Q000601:surgery; D014948:Wounds, Gunshot / Q000401:mortality / Q000601:surgery