Analysis of septic morbidity following gunshot wounds to the colon

The missile is an adjuvant for abscess

H. A. Poret, Timothy C. Fabian, Martin Croce, Raymond P. Bynoe, Kenneth A. Kudsk

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Over a 7-year period, 151 patients with gunshot wounds to the colon surviving beyond 24 hours were managed. The bullet was retained in the body in 66% and exited in 34%. Thirty-four (23%) developed major septic complications (diffuse peritonitis, 21%; intraperitoneal abscesses, 24%; and extraperitoneal abdominal abscesses, 56%). The septic complication rate was 26% in the bullet-present group compared with 16% in the remainder (p < 0.15). The increased septic rate in those with bullets present was the result of abscesses developing around the retained missile. That group with missile abscesses had a lesser degree of injury as measured by the abdominal trauma index compared with the other patients with septic complications (p < 0.001). Fifteen (79%) of the 19 patients with missile and missile track abscesses had them develop in the psoas muscle. These abscesses occur by fecal contamination of the muscle following inoculation by the bullet, which passes through the large bowel. Computed tomography-guided and operative drainage tend to fail if the foreign body is not removed. Computed tomography-guided or operative drainage should be successful in draining missile track abscesses when the bullet has exited the patient.

Original languageEnglish (US)
Pages (from-to)1088-1095
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume31
Issue number8
DOIs
StatePublished - Jan 1 1991

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Gunshot Wounds
Abscess
Colon
Morbidity
Drainage
Tomography
Psoas Muscles
Abdominal Abscess
Wounds and Injuries
Foreign Bodies
Peritonitis
Muscles

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Analysis of septic morbidity following gunshot wounds to the colon : The missile is an adjuvant for abscess. / Poret, H. A.; Fabian, Timothy C.; Croce, Martin; Bynoe, Raymond P.; Kudsk, Kenneth A.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 31, No. 8, 01.01.1991, p. 1088-1095.

Research output: Contribution to journalArticle

Poret, H. A. ; Fabian, Timothy C. ; Croce, Martin ; Bynoe, Raymond P. ; Kudsk, Kenneth A. / Analysis of septic morbidity following gunshot wounds to the colon : The missile is an adjuvant for abscess. In: Journal of Trauma - Injury, Infection and Critical Care. 1991 ; Vol. 31, No. 8. pp. 1088-1095.
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