Abstract
BACKGROUND: Gunshot wounds to the buttocks may cause significant intra-abdominal injuries. Policies of aggressive abdominal exploration or extensive diagnostic testing have been suggested to avoid delays in treatment and consequent morbidity. Our group has recently suggested that clinical examination is a safe and reliable tool for triaging patients with anterior and posterior abdominal gunshot wounds. OBJECTIVE: This study was undertaken to test the hypothesis that patients with gunshot wounds to the buttocks can be managed selectively on the basis of clinical findings. SETTING: A large academic Level I trauma center was the setting for this study. PATIENTS AND METHODS: Fifty-nine consecutive patients, suffering from gunshot wounds to the buttocks with potential retroperitoneal trajectories, were managed during a 12-month period in our center. RESULTS: Based on clinical findings, 19 (32.2 percent) patients were operated on, with significant intra-abdominal injuries in 17 (28.8 percent). The remaining 40 (67.8 percent) patients were successfully observed. There were no missed injuries or delays in diagnosis. Sensitivity and specificity of clinical examination for identifying significant intra-abdominal injury was 100 percent and 95.3 percent, respectively. CONCLUSION: Clinical examination is a safe method for selecting patients with gunshot wounds to the buttocks for nonoperative treatment.
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Coppa GF, Davalle M, Pachter HL, Hofstetter HF. Management of penetrating wounds of the back and flank. Surg Gynecol Obstet 1984;159:514–8.
Vanderzee J, Christenberry P, Jurkovich GJ. Penetrating trauma to the back and flank. Am Surg 1987;53:220–2.
Henao F, Jimenez H, Tawil M. Penetrating wounds of the back and flank: analysis of 77 cases. South Med J 1987;80:21–5.
Demetriades D, Velmahos GC, Cornwell EE III,et al. Selective nonoperative management of gunshot wounds of the anterior abdomen. Arch Surg (in press).
Maull KI, Snoddy J, Haynes BW Jr. Penetrating wounds of the buttock. Surg Gynecol Obstet 1979;169:855–7.
DiGiacomo JC, Schwab CW, Rotondo MF,et al. Gluteal gunshot wounds: who warrants exploration? J Trauma 1994;37:622–8.
Duncan AO, Phillips TP, Scalea TM, Maltz SB, Atweh NA, Sclafani SJ. Management of transpelvic gunshot wounds. J Trauma 1989;29:1335–40.
Mercer D, Buckman RF, Sood R, Kerr T, Gelman J. Anatomic considerations in penetrating gluteal wounds. Arch Surg 1992;127:407–10.
Vo NM, Rüssel JC, Becker DR. Gunshot wounds to the buttocks. Am Surg 1983;49:579–81.
Feraro FJ, Livingston DH, Odom J, Swan KG, McCormack M, Rush BF Jr. The role of sigmoidoscopy in the management of gunshot wounds to the buttocks. Am Surg 1993:59:350–2.
Peck JJ, Berne TV. Posterior abdominal stab wounds. J Trauma 1981;21:298–302.
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Velmahos, G.C., Demetriades, D., Cornwell, E.E. et al. Gunshot wounds to the buttocks. Dis Colon Rectum 40, 307–311 (1997). https://doi.org/10.1007/BF02050420
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DOI: https://doi.org/10.1007/BF02050420