title: Contribution of imaging in the initial management of ballistic trauma.
abstract: BACKGROUND
  The purpose of this study is to specify the role of imaging in the initial management of ballistic traumas.
  
  
  METHODS
  This is a retrospective study that colligated 83 victims of a gunshot wound during demonstrations, treated in our trauma centre between 12 January and 3 February 2011. All of the patients were haemodynamically stable and examined by conventional radiography and/or ultrasound and/or 16-slice CT-scan (CT).
  
  
  RESULTS
  The mean age of the victims was 26years with a sex ratio of 0.02. All wounds were unique. Injury to the limbs was most common in 75.5% of the cases (n=64) followed by that of the torso in 19.5% of the cases (n=16). Wounds in the spine (n=2), brain (n=2) and facial skeleton (n=1) were observed. Conventional x-rays objectified 32 cases of open fractures 95% of which were in the legs. Twenty-one of the victims of gunshot wounds had a CT-scan that objectified the path of the bullet and an assessment of the wound was made in all cases. The confrontation of the data from the CT-scan and that noted during surgery and during the monitoring demonstrated that the CT-scan is very efficient in the diagnosis of pleural effusion, vascular wounds, thoracic parenchymatous wounds and wounds of the solid organs and brain lesions and the facial skeleton. However, the sensitivity is low for the diagnosis of hollow organs.
  
  
  CONCLUSIONS
  The CT-scan is very useful in the initial care of stable patients with gunshot wounds as regards the haemodynamics and helps objectify the path of the bullet and obtain a precise assessment of the damage. Conventional x-rays are unavoidable for wounds to the legs and spine.
authors.affiliation: Service d'imagerie médicale, centre de traumatologie et des grands brûlés, 1013 Tunis, Tunisia. Electronic address: alifa_daghfous@yahoo.fr.
authors.forename: A
authors.initials: A
authors.lastname: Daghfous
authors.affiliation: Service d'imagerie médicale, hôpital Taher Maâmouri, Nabeul, Tunisia.
authors.forename: K
authors.initials: K
authors.lastname: Bouzaïdi
authors.affiliation: Service de chirurgie orthopédique, centre de traumatologie et des grands brûlés, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Abdelkefi
authors.affiliation: Service de chirurgie générale, centre de traumatologie et des grands brûlés, Tunis, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Rebai
authors.affiliation: Service de chirurgie générale, centre de traumatologie et des grands brûlés, Tunis, Tunisia.
authors.forename: A
authors.initials: A
authors.lastname: Zoghlemi
authors.affiliation: Service de chirurgie orthopédique, centre de traumatologie et des grands brûlés, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Mbarek
authors.affiliation: Service d'imagerie médicale, centre de traumatologie et des grands brûlés, 1013 Tunis, Tunisia.
authors.forename: L
authors.initials: L
authors.lastname: Rezgui Marhoul
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Computed tomography; Conventional x-ray; Gunshot wound; Trauma; Ultrasound