Characteristics of penetrating abdominal firearm injuries in children

Penetrating injuries of the abdomen which occur primarily from gunshots and stabbing become increasingly prevalent in children. Our purpose is to asse ss the presentation, management and outcome of children with penetrating ab dominal firearm injuries (PAFI) and to evaluate the value of Injury Severit y Score (ISS) for predicting injury severity and eventual morbidity and mor tality in children with PAFI. Between 1985 and 1997, 69 children less than or equal to 15 years of age with PAFI were hospitalized at our institution. Their hospital records were reviewed retrospectively. Of the 69 children w ith PAFI, 53 were boys and 16 were girls. The mean age was 9.6. The causes of PAFI were explosives (44%), gunshot (39%) and shotgun injuries (17%). Th e most common organ injured was the small bowel followed by colon and liver respectively. Postoperative complications were seen in 12 children. The me an value of ISS was 16.8: 41 children had an ISS value of greater than or e qual to 16. The value of ISS was significantly higher in children with comp lication than in those without complication. The children with ISS value gr eater than or equal to 16 were hospitalized significantly longer than those with less than or equal to 15 of ISS. Particularly shotgun injuries were c ommonly associated with severe morbidity. ISS can be useful for predicting the severity of injury and the occurrence of morbidity.