TRUNCAL GUNSHOT WOUNDS IN FINLAND, 1985 TO 1989

A nationwide survey of truncal gunshot wounds identified 119 patients managed in 34 institutions, The wounds resulted from low-velocity bull ets in 69%, high-velocity bullets in 6%, and shotgun pellets in 25%, T he thoracic or abdominal cavity was penetrated in 62%, and the mean In jury Severity Score was 16 (range, 1 to 57), The wounding capacity of close-range shotgun pellets equaled that of high-velocity bullets, whe reas long-range (>10 meters) shotgun injuries resembled air rifle inju ries in their poor ability to penetrate deeper structures and cause in ternal injuries, A thoracotomy or sternotomy was required in 31% of th e penetrating thoracic injuries, Of 57 laparotomies, 9% were negative, In four cases (7% of all laparotomies), a significant abdominal organ injury was overlooked at the initial operation, emphasizing the impor tance of meticulous exploration of all abdominal organs, and especiall y the diaphragm and the retroperitoneal structures.