Abstract
The nonoperative treatment of anterior abdominal gunshot wounds remains controversial. This article presents a narrative review of the literature after the selection of studies in electronic databases (PubMed, Cochrane Library and Lilacs), with the intention of evaluating the clinical and diagnostic tools that should be part of conservative selective approach of these lesions. It was observed that a nonoperative selective treatment can be effectively and safely used, when performed by a trained interdisciplinary team, working in adequate trauma centers. The selective nonoperative treatment is associated with a decrease in negative and nontherapeutic laparotomies, reducing the incidence of complications. It also contributes to the reduction of hospital costs.
Highlights
Surgical treatment of gunshot wounds that penetrate the abdominal cavity is the traditional, standard one[1]
The reason for this conduct is that these wounds are still believed to cause a high incidence of intra-abdominal injuries, and that the occurrence of complications in a negative laparotomy would not justify an attempt of conservative treatment in such injuries
Based on the title and abstract, we looked for relevant papers, addressing the conservative treatment of abdominal gunshot wounds, selecting 12 articles on the topic (Figure 1)
Summary
Surgical treatment of gunshot wounds that penetrate the abdominal cavity is the traditional, standard one[1]. The injuries caused by firearm projectiles in the abdominal cavity, are still treated with mandatory surgical exploration in most hospitals. The reason for this conduct is that these wounds are still believed to cause a high incidence of intra-abdominal injuries, and that the occurrence of complications in a negative laparotomy would not justify an attempt of conservative treatment in such injuries. The worldwide trend to always intervene surgically in this type of injury is still well accepted in most services for traumatized victims of abdominal perforations caused by firearm projectiles. The lack of scientific evidence and protocols corroborates to maintain surgical treatment as the standard one[1,3,4]
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