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June 1974

Visceral Injury Due to Extraperitoneal Gunshot Wounds

Author Affiliations

Los Angeles
From the Department of Surgery, University of Southern California School of Medicine and the Los Angeles County-University of Southern California Medical Center, Los Angeles.

Arch Surg. 1974;108(6):865-866. doi:10.1001/archsurg.1974.01350300095022

Of 200 consecutive low-velocity abdominal gunshot wounds, 35 (17.5%) had nonpenetration of the peritoneal cavity as proved by celiotomy. Of these 35 patients, 30 (86%) did not have visceral injury while five sustained at least one visceral injury. Four of these patients sustained only minor visceral contusions not requiring surgical therapy. The fifth patient underwent exploration of an extraperitoneal bullet track with proof of peritoneal nonpenetration. The track passed beneath the deep fascia. This patient developed a jejunal perforation on the fourth hospital day and subsequently underwent celiotomy and repair. Thirty-four of our 35 patients with proven peritoneal nonpenetration did well with no surgical therapy, though penetration of the deep fascia with an intact peritoneum led to visceral injury in the case here reported.

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