Shotgun wounds to the abdomen

J. A. Glezer, G. Minard, Martin Croce, T. C. Fabian, K. A. Kudsk

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

In 1963 Sherman and Parrish (Sherman RT, Parrish RA. Management of shotgun Injuries: A Review of 152 Cases. J Trauma 1963;3:76-86) classified shotgun wounds into three types based upon distance and penetration. Because distances are often unknown, we redefined Sherman's groups by pellet scatter. Type I patients had >25 cm of scatter, Type II had <25 cm but >10 cm, and Type III had <10 cm. Seventy-one abdominal shotgun wound patients were admitted over 8 years. Eight tangential wounds were managed by local wound care. Of the remaining 63, 27 were Type I, 10 were Type II, and 26 Type III. Two Type II and six Type III patients died within 24 hours. All required laparotomy. Nine of the Type I patients required laparotomy; eight had peritoneal signs and one had progressive abdominal tenderness, hypotension, and intra-abdominal pellets. Eighteen Type I patients without peritoneal signs were observed without complications. Type III patients suffered more vascular injuries and presented more frequently with hypotension than Type II patients. Of the patients surviving greater than 24 hours, Type IIIs received more transfusions and stayed longer in the intensive care unit and hospital than Type IIs. They also suffered more complications than Type IIs. Seven Type III patients required complicated reconstruction of the abdominal wall. Classification of abdominal shotgun injuries using pellet spread is a more useful system in determining patient management and prognosis compared to systems based on distance. Type II and III abdominal shotgun injuries require laparotomy, debridement of soft tissue injuries and frequently reconstruction of abdominal wall defects. Type I injuries can be managed effectively using signs of peritoneal irritation or progressive abdominal tenderness as the best indicator of the need for operation.

Original languageEnglish (US)
Pages (from-to)129-132
Number of pages4
JournalAmerican Surgeon
Volume59
Issue number2
StatePublished - 1993

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Firearms
Abdomen
Wounds and Injuries
Laparotomy
Abdominal Injuries
Abdominal Wall
Hypotension
Soft Tissue Injuries
Vascular System Injuries
Debridement
Intensive Care Units

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Glezer, J. A., Minard, G., Croce, M., Fabian, T. C., & Kudsk, K. A. (1993). Shotgun wounds to the abdomen. American Surgeon, 59(2), 129-132.

Shotgun wounds to the abdomen. / Glezer, J. A.; Minard, G.; Croce, Martin; Fabian, T. C.; Kudsk, K. A.

In: American Surgeon, Vol. 59, No. 2, 1993, p. 129-132.

Research output: Contribution to journalArticle

Glezer, JA, Minard, G, Croce, M, Fabian, TC & Kudsk, KA 1993, 'Shotgun wounds to the abdomen', American Surgeon, vol. 59, no. 2, pp. 129-132.
Glezer JA, Minard G, Croce M, Fabian TC, Kudsk KA. Shotgun wounds to the abdomen. American Surgeon. 1993;59(2):129-132.
Glezer, J. A. ; Minard, G. ; Croce, Martin ; Fabian, T. C. ; Kudsk, K. A. / Shotgun wounds to the abdomen. In: American Surgeon. 1993 ; Vol. 59, No. 2. pp. 129-132.
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