2010, Number 1
Penetrating abdominal trauma: a comparison of morbidity and mortality in gunshot wounds and stab wounds
Díaz-Rosales JD, Arriaga-Carrera JM, Enríquez-Domínguez L, Castillo-Moreno JR, Montes-Castañeda JG
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Language: Spanish
References: 10
Page: 24-28
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ABSTRACT
Objective: We report the differences in morbidity and mortality of penetrating abdominal trauma caused by stab wounds and gunshot wounds.Setting: General Hospital of Ciudad Juárez (second level health care hospital).
Design: Prospective, comparative study.
Statistical analysis: Percentages as summary measure of qualitative variables and Pearson’s χ2 test.
Patients and methods: Patients with penetrating abdominal trauma subjected to exploratory laparotomy in the period from April 2008 to November 2009. We included all patients with penetrating abdominal trauma due to stab wounds and/or gunshot wounds. Patients were divided in two groups: group A, gunshot wound, and B, stab wounds. The dependent variables studied were: age, gender, injury mechanism, number of injuries, associated extra-abdominal injuries, injury to an intraabdominal organ, type of laparotomy, surgical time, complications inherent to the trauma, postsurgical complications, days of in-hospital stay, and mortality.
Results: We studied 356 patients, 206 with gunshot wounds and 150 with stab wounds. The average age of patients was 28.9 years, average injuries in group A corresponded to the upper limbs, whereas, in group B, injuries corresponded to the thorax. The intra-abdominal organ most injured was the colon in group A, whereas in group B it was the small intestine. Most laparotomies for damage control were performed in group A, whereas most of the non-therapeutic laparotomies were performed in group B. The difference in the hemoperitoneum was of more than 687 ml for group A, surgical time was also higher (18 min more) in this group. Group A presented a total of 102 complications vs 29 complications in group B. Hypovolemic shock was the most frequent post-traumatic complication, and infection of the surgical site was the most common post-surgical complication. Mortality was higher in group A, lethal triad and sepsis were the main causes of death.
Conclusions: Complications related to gunshot wounds are greater, as well as mortality. This is caused by the hypovolemic shock/lethal triad, followed by sepsis. Although stab wounds have a better prognosis, they are not exempt of complications and mortality.
REFERENCES
Díaz-Rosales JD, Enríquez-Domínguez L, Arriaga-Carrera JM, Cabrera-Hinojosa JE, Gutiérrez-Domínguez PG. Trauma penetrante abdominal con lesión en intestino delgado, aislada y asociada a otros órganos: La relación respecto a la morbilidad y mortalidad en Ciudad Juárez, Chihuahua. Cir Gen 2009; 31: 91-96.