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2015 ; 8
(4
): 6154-62
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gab.com Text
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Complications and risk factors for mortality in penetrating abdominal firearm
injuries: analysis of 120 cases
#MMPMID26131219
Iflazoglu N
; Ureyen O
; Oner OZ
; Tusat M
; Akcal MA
Int J Clin Exp Med
2015[]; 8
(4
): 6154-62
PMID26131219
show ga
Due to the high kinetic energy, of bullets and explosive gun particles, their
paths through the abdomen (permanent cavity effect), and the blast effect
(temporary cavity effect), firearm injuries (FAI) can produce damage not only in
the organ they enter, but in the surrounding tissues as well. Since they change
route after entering the body they may cause organ damage in locations other than
those at the path of entry. For example, as a result of the crushing onto bone
tissues, bullet particles or broken bone fragments may cause further damage
outside of the path of travel, For these reasons it is very difficult to predict
the possible complications from the size of the actual injury in patients with
penetrating abdominal firearm injuries. The factors affecting the mortality and
morbidity from firearm injuries have been evaluated in various studies.
Insufficient blood transfusion, long duration of time until presenting to a
hospital and the presence of colon injuries are common factors that cause the
high complication rates and mortality. A total of 120 cases injured in the civil
war at Turkey's southern neighbouring countries were admitted to our hospital and
evaluated in terms of: development of complications and factors affecting
mortality; age, gender, time of presentation to the hospital, number of injured
organs, the type of injuring weapon, the entrance site of the bullet, the
presence of accompanying chest trauma, the amount of administered blood, the
penetrating abdominal trauma index (PATI) and the injury severity score (ISS)
scores were determined and evaluated retrospectively. The most significant
factors for the development of complications and mortality include: accompanying
clinical shock, high number of injured organs, numerous blood transfusions
administered and accompanying thoracic trauma. It has also been observed that the
PATI and ISS scoring systems can be used in predicting the complication and
mortality rates in firearm injuries. Consequently, reducing the mortality and
complication rates from firearm injuries is still a serious problem. Despite all
of these efforts, there is still a need to determine the optimum treatment
strategy to achieve this end goal.