Journal of Current Surgery, ISSN 1927-1298 print, 1927-1301 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Curr Surg and Elmer Press Inc
Journal website http://www.currentsurgery.org

Original Article

Volume 5, Number 4, December 2015, pages 199-203


Non-Operative Management of Thoracoabdominal Gunshot Injury: Thirteen Unusual Cases

Figures

Figure 1.
Figure 1. (a) In an 8-month pregnant patient with gunshot wound to abdomen, the coronal reformat CT shows a bullet in just the right neighborhood of the abdominal aorta. There is no abdominal parenchymal organ injury. (b) In a patient with gunshot wound to the thoracoabdomen, the sagittal reformat CT demonstrates superior splenic laceration. There are small retroperitoneal fat herniations through a posterior left diaphragm defect (Bochdalek hernia) and minimal fluid and injury in the left hemithorax. (c) The sagittal reformat CT of a patient with gunshot wound to the abdomen shows subcapsular hematoma and laceration in the right liver. There is a bullet next to a posterior rib. (d) The axial CT of a patient with gunshot wound to the abdomen shows a bullet in the periportal area. The hepatic artery and portal vein are patent. There is no abdominal organ injury.
Figure 2.
Figure 2. (a) Defect of the diaphragm in laparoscopic exploration. (b) Repaired two diaphragmatic defects.

Table

Table 1. Demographic Features of the Patients
 
CaseAgeGenderTTI (min)Injured organTreatmentHospital stay (days)
*Pregnant. TTI: trauma-treatment interval.
137M50Left side diaphragm, vertebra and spleen (grade II)Medical treatment and delayed laparoscopic diaphragm repair7
234M30Right diaphragm and liver (grade I)Medical treatment and elective diaphragm repair8
344M40Right side diaphragm and liver (grade II)Medical treatment and diaphragm repair10
448M45Liver (grade I)Medical8
5*18F30Liver (grade II) and vertebraMedical8
633F50Liver (grade II)Medical12
720M60Liver (grade I)Medical5
824F60Liver (grade II)Medical13
9*25F90RetroperitoneumMedical7
1035M60TangentialMedical3
1145M40TangentialMedical2
1225M60TangentialMedical2
1336M50TangentialMedical3