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Transabdominal gunshot wounds of the hip and pelvis
Ist Teil von
Journal of the American Academy of Orthopaedic Surgeons, 2013-05, Vol.21 (5), p.286
Ort / Verlag
United States
Erscheinungsjahr
2013
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Transabdominal gunshot wounds (GSWs) of the hip and pelvis are those that traverse the gastrointestinal system before entering the pelvis and/or hip. These injuries may be contaminated by bowel contents. Some require urgent surgical intervention; others can be managed nonsurgically. A primary survey with attention to hemodynamic status is of utmost priority. After obtaining hemodynamic stability and addressing abdominal injuries, careful attention must be paid to evaluating hip joint involvement and injuries to the genitourinary and vascular systems. The available literature shows that transabdominal GSW with intra-articular contamination should be urgently débrided and irrigated; extra-articular transabdominal GSW with stable fracture patterns may be managed with observation and empiric antibiotics. Extent of soft-tissue injury dictates the need for wound débridement. Bullets lodged in intra-articular locations should be removed, but retained bullets in other anatomic locations do not necessarily warrant removal.