Conservative Management of Gunshot Wound to Anterior Abdomen in a Resource-Poor Setting in the Caribbean.

Autor: Islam S; General Surgery, San Fernando General Hospital, San Fernando, TTO.; Clinical Surgical Sciences, The University of the West Indies, St. Augustine, TTO., Ramnarine M; General Surgery, San Fernando General Hospital, San Fernando, TTO.; Clinical Surgical Sciences, The University of the West Indies, St. Augustine, TTO., Maughn A; General Surgery, San Fernando General Hospital, San Fernando, TTO.; Clinical Surgical Sciences, The University of the West Indies, St. Augustine, TTO., Chandolu K; Radiology, San Fernando General Hospital, San Fernando, TTO., Naraynsingh V; Clinical Surgical Sciences, The University of the West Indies, St. Augustine, TTO.; Surgery, Medical Associates Hospital, St. Joseph, TTO.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2021 Jul 31; Vol. 13 (7), pp. e16789. Date of Electronic Publication: 2021 Jul 31 (Print Publication: 2021).
DOI: 10.7759/cureus.16789
Abstrakt: Previously, the management of gunshot wounds (GSWs) to the anterior abdomen required exploratory laparotomy; however, this was associated with a considerable number of non-therapeutic surgeries. The use of non-operative management (NOM) of GSW to the abdomen is controversial, with many surgeons sceptical to accept this into their practice. The NOM of GSW to the abdomen employed in a selected group of patients has been shown to be safe and acceptable. Penetrating GSW to the thoraco-abdomen, back and lateral abdomen has been the most successful compared to the anterior penetrating wound. Most of the anterior GSWs to the abdomen are associated with viscus injury and require exploratory laparotomy. We report the case of a 58-year-old male who presented with a single GSW to the epigastrium with a contrast computed tomography scan demonstrating grade 3 liver lacerations, contusion to the right adrenal gland, with moderate free fluids in the retroperitoneum and the pelvis. The patient was haemodynamically stable and managed successfully with NOM. It is one of the safe routes of anterior penetration of GSW to the abdomen and treated with conservative management.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2021, Islam et al.)
Databáze: MEDLINE