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Journals / Ulusal Travma ve Acil Cerrahi Dergisi / 2018 / Cilt: 24 - Sayı: 1

Operative and non-operative management of children with abdominal gunshot injuries

Mehmet Şerif ARSLAN
HİKMET ZEYTUN
Serkan ARSLAN
EROL BASUGUY
Mehmet Hanifi OKUR
BAHATTİN AYDOĞDU
CEMİL GÖYA
İBRAHİM UYGUN
Selçuk OTÇU
Pages
61–65
DOI
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⚡ TL;DR(Too Long; Didn't Read)

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

📌 3 Key Takeaways

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Objective & Hypothesis:BACKGROUND: Non-operative management (NOM) is a standard treatment method for solid organ injuries worldwide.
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Key Findings & Data: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.
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Conclusion & Impact: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
🔬Design:Research Article
📍Scope:2010 Verileri
⚙️Variables:Domain Parameters

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

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Cite This Article

ARSLAN, M. Ş., ZEYTUN, H., ARSLAN, S., BASUGUY, E., OKUR, M. H., AYDOĞDU, B., GÖYA, C., UYGUN, İ., OTÇU, S. (2018). Operative and non-operative management of children with abdominal gunshot injuries. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 24 - Sayı: 1, 61–65. https://ajindex.com/articles/323967

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