Portal de Periódicos da CAPES

When to Operate on Abdominal Gunshot Wounds

2002; SAGE Publishing; Volume: 91; Issue: 1 Linguagem: Inglês

10.1177/145749690209100110

1799-7267

Alí Salim, George C. Velmahos,

Trauma and Emergency Care Studies

Historically, penetrating abdominal trauma was managed expectantly until the late 19 th century. In World War I, with the high mortality and morbidity associated with penetrating abdominal trauma, operative management replaced expectant management. It was soon realized that not all penetrating abdominal injuries required an operation. Since the 1960's, selective nonoperative management of stab wounds to the anterior abdomen has become the standard of care. However, gunshot wounds to the abdomen are still treated by mandatory exploration based on an allegedly high incidence of ***intraabdominal injuries and low rate of complications, if laparotomy turns out negative. A number of series have recently surfaced, reporting successful outcomes, while decreasing morbidity and hospital length of stay, with selective non-operative management of gunshot wounds to the abdomen. This review will address the current controversies surrounding selective nonoperative management of gunshot wounds to the abdomen and will present our experience and current approaches.