Citation

Leppaniemi A, Cederberg A, Tikka S. J. Trauma 1996; 40(3 Suppl): S217-22.

Affiliation

Second Department of Surgery (A.L.), Helsinki University Central Hospital, Finland.

Copyright

(Copyright © 1996, Lippincott Williams and Wilkins)

DOI

unavailable

PMID

8606413

Abstract

A nationwide survey of truncal gunshot wounds identified 119 patients managed in 34 institutions. The wounds resulted from low-velocity bullets in 69%, high-velocity bullets in 6%, and shotgun pellets in 25%. The thoracic or abdominal cavity was penetrated in 62%, and the mean Injury Severity Score was 16 (range, 1 to 57). The wounding capacity of close-range shotgun pellets equaled that of high-velocity bullets, whereas long-range (>10 meters) shotgun injuries resembled air rifle injuries in their poor ability to penetrate deeper structures and cause internal injuries. A thoracotomy or sternotomy was required in 31% of the penetrating thoracic injuries. Of 57 laparotomies, 9% were negative. In four cases (7% of all laparotomies), a significant abdominal organ injury was overlooked at the initial operation, emphasizing the importance of meticulous exploration of all abdominal organs, and especially the diaphragm and the retroperitoneal structures.