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Surgery pp 425-433 | Cite as

Penetrating Abdominal Trauma

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Abstract

A 24-year-old male is brought to the emergency room following a gunshot wound (GSW) to the left lower abdomen. On initial examination, his blood pressure is 80/65 mmHg, heart rate is 140/min, and respiratory rate is 26/min. He appears pale and is diaphoretic. He is unable to remain still secondary to pain. The patient’s airway is patent and there are equal breath sounds bilaterally. He has a rigid abdomen with diffuse tenderness, guarding, and rebound. There is a single entry wound to the left lower quadrant. No other GSWs are noted on exam. Palpation of the patient’s lower extremity pulses reveals a diminished left femoral pulse and a normal right femoral pulse. His left leg is cool to touch. The patient is urgently taken to the operating room.

Keywords

Penetrating Abdominal Trauma DPL FAST Laparotomy Massive transfusion protocol Permissive hypotension Nonoperative management Abdominal compartment syndrome 

Suggested Reading

  1. Nicholas JM, Rix EP, Easley KA, et al. Changing patterns in the management of penetrating abdominal trauma: the more things change, the more they stay the same. J Trauma. 2003;55:1095.CrossRefPubMedGoogle Scholar
  2. Velmahos GC, Demetriades D, Toutouzas KG, et al. Selective nonoperative management in 1,856 patients with abdominal gunshot wounds: should routine laparotomy still be the standard of care? Ann Surg. 2001;234:395.CrossRefPubMedCentralPubMedGoogle Scholar
  3. Zafar SN, Rushing A, Haut ER, et al. Outcome of selective non-operative management of penetrating abdominal injuries from the North American National Trauma Database. Br J Surg. 2012;99 Suppl 1:155.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of SurgeryHarbor-UCLA Medical CenterTorranceUSA
  2. 2.Department of SurgeryUniversity of California, IrvineOrangeUSA

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