NONOPERATIVE MANAGEMENT OF GUNSHOT WOUNDS OF THE ABDOMEN

Nonoperative management of stab wounds of the abdomen is currently pra cticed in many trauma centers; this report examines the role of expect ant management of gunshot wounds to the abdomen in a select patient po pulation. Patients presenting to a single trauma service from 5/91 to 1/94 at Detroit Receiving Hospital with a gunshot wound (GSW) to the a bdomen fulfilling the following criteria were observed: 1) single GSW to the right upper quadrant, 2) stable vital signs, 3) reliable examin ation with minimal abdominal tenderness and available team/operating r oom, and 4) minimal or no abdominal tenderness. There were 12 patients fulfilling the study criteria; all were successfully observed. One no ntherapeutic laparotomy was done due to abdominal tenderness. The role of expectant therapy of abdominal gunshot wounds is cautiously advanc ed. With appropriate criteria, this technique appears safe and efficac ious.