title: Civilian abdominal gunshot wounds in Lagos.
abstract: This prospective study of 78 patients who sustained abdominal gunshot wounds was performed to evaluate the pattern of injuries, treatment outcome and the role of selective conservative management. Three (3.8%) patients died before laparotomy. Four (5.1%) patients with superficial wounds were managed by local wound care. Fourteen (18%) patients who had equivocal or minimal abdominal signs were selected for conservative management. Laparotomy was performed in 57 (73.1%) patients who presented with an acute abdomen. The commonly injured organs were the small bowel (56.1%), colon (38.6%), liver (22.8%) and stomach (19.3%). Prolonged injury to arrival and surgical intervention time were contributing factors to the high incidence of sepsis (63.2%) and mortality (22.8%) after laparotomy. Two patients selected for conservative management required delayed laparotomy, one of which was negative. A 10-fold increase in prevalence of abdominal gunshot wounds has occurred in our institution in the 1990s. Selective conservative management is feasible without the use of expensive investigations.
authors.affiliation: Department of Surgery, Lagos University Teaching Hospital and College of Medicine, Negeria.
authors.forename: A A
authors.initials: AA
authors.lastname: Adesanya
authors.forename: I R
authors.initials: IR
authors.lastname: Afolabi
authors.forename: J T
authors.initials: JT
authors.lastname: da Rocha-Afodu
mesh_terms: D000006:Abdomen, Acute / Q000601:surgery; D000007:Abdominal Injuries / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*