[Abdominal gunshot wounds: possibilities for selective conservative management].
Two men aged 45 and 26 years, respectively, presented with abdominal gunshot wounds and were treated successfully using a nonsurgical approach. Normally, abdominal gunshot wounds are treated surgically in the Netherlands. This policy produces negative laparotomy findings in 22-41% of procedures. With an increasing number of gunshot wound patients presenting to emergency departments, a better understanding of abdominal gunshot wounds is needed. Immediate laparotomy is indicated for patients with haemodynamic instability, signs of peritonitis or massive intra-abdominal fluid visible with focused abdominal ultrasonography for trauma. However in selected cases and with the use of strict diagnostic and follow-up procedures, it is possible to treat these patients with a nonsurgical approach. Physical examination, adequate CT investigation and possibly additional radiological evaluation play a pivotal role in this approach. Therefore, assessment by a multidisciplinary trauma team is crucial at the time of presentation and during further treatment for abdominal gunshot wounds. Ned Tijdschr Geneeskd.
van den Berg
H R
HR
Lere
S G
SG
Schipper
I B en
IB
Patka
P
P
D000007:Abdominal Injuries / Q000628:therapy*; D000328:Adult; D004632:Emergency Medical Services / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012307:Risk Factors; D012449:Safety; D014948:Wounds, Gunshot / Q000628:therapy*