Abstract:

Though the injuries of the cutting-edge instrument penetrated into the stomach emptiness are monitored conservatively and negative laparotomies are reduced, there are still no criteria for tracking in firearm injuries that are accepted. In this study we conducted in cases referring to our clinic, we examined our negative laparotomy rate in cases of firearm in the front wall of the abdomen. During the last 5 years (1 January 1999 – 1 January 2004) 41 cases that apply to our clinic have been examined retrospectively. The average age of these 41 events was 30.5 (14-75), and the male/woman ratio was 35/6. Thirty-seven (90.2%) cases were taken to direct laparotomy, while 4 (9.8%) cases were evaluated by diagnostic periton washing, laparotomy was not applied. Inside empty organ injuries occurred in 28 cases (68.2%), while solid organ injuries occurred in 16 cases (38.9%). In three cases (8.1) there was no laparotomy injury. In total 41 cases there were 7 (17.1%) cases of injury in the abdominal organs that did not develop. Laparotomy is inevitable in cases of injuries with firearms, with acute abdominal symptoms in physical examination, hemodynamicly unstable. In our study, 17% of the injuries that would require surgery in the case and mortality in these cases did not develop. We believe that the phenomena that are hemodynamicly stable and not sensitive to the stomach, which do not require radiological surgery, can be followed without laparotomy. In such cases, clinical observation, diagnostic peritoneal washing or diagnostic laparoscopy may be preferred.

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