Operative and non-operative management of children with abdominal gunshot injuries
Yükleniyor...
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ulusal Travma ve Acil Cerrahi Derneği
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ABSTRACT: BACKGROUND: Non-operative management (NOM) is a standard treatment method for solid organ injuries worldwide. There
is no consensus on the management of gunshot wounds (GSW) because of the higher frequency of hollow viscus injuries (HVI) and
the unpredictable depth of tissue damage produced by kinetic energy transfer during retardation of the bullet. Here we aimed to reevaluate indications for surgery and NOM based on our pediatric patients with abdominal GSW.
METHODS: We performed a retrospective analysis of patients evaluated and treated for abdominal GSW at University of Dicle
between January 2010 and October 2016. Patients with hemodynamic instability, signs of peritonitis on serial abdominal examination,
and free air in the abdomen underwent laparotomy; these were included in group I (n=17). Patients managed non-operatively were
included in group II (n=13).
RESULTS: Our statistical analysis showed significantly lower Hb levels and systolic blood pressure levels (p<0.001) and higher pulse
rate, higher mean injury severity score, and longer length of stay at intensive care unit in patients in group I than in those in group
II (p<0.001). We further detected colon perforation (n=10) and small bowel perforation (n=7) in patients in group I; liver laceration
(n=4), splenic injury (n=1), and renal injury (n=3) but no solid organ injury or HVI (n=5) were detected in patients in group II.
CONCLUSION: The major drawback of NOM is the difficulty in diagnosing HVI in abdominal GSW, which may delay treatment. We
suggest that patients with solid organ damage who are hemodynamically stable and exhibit no signs of peritonitis upon serial abdominal
exam may be treated with NOM.
Açıklama
Anahtar Kelimeler
Children, Gunshot injuries, Hollow viscus injuries, Non-operative management
Kaynak
Ulusal Travma ve Acil Cerrahi Dergisi
WoS Q Değeri
Q4
Scopus Q Değeri
Cilt
24
Sayı
1
Künye
Arslan, M. Ş., Zeytun, H., Arslan, S., Basuguy, E., Okur, M. H., Aydoğdu, B. ve diğerleri. (2018). Operative and non-operative management of children with abdominal gunshot injuries. Ulusal Travma ve Acil Cerrahi Dergisi, 24(1), 61-65.
