Transfixing abdominal gunshot wound without intra-abdominal lesions: A case report
Abstract Background Abdominal gunshot trauma is considered the third leading cause of death in the USA and is responsible for more than 90% of deaths among young people aged 15 to 24. It leads to multi-systemic organ damage, shock, and infection. Case presentation A 20-year-old male alcohol and tobacco user with no relevant health history was admitted at Hôpital de l’Université d’Etat d’Haïti, in the emergency Surgery Department for an abdominal bullet wound. The initial clinical examination was unremarkable except for the presence of hemorrhagic lesions. A few hours later, the patient became diaphoretic, complained of abdominal pain. In view of his rapidly developing condition, he was prepared for the operating room. An exploratory laparotomy was performed, in which 100 cc of blood was found effusing into the abdominal cavity, without any intraperitoneal visceral damage. Systematic exploration showed retroperitoneal hematomas in zone II, where a wound in the psoas muscle was found on the posterior left, in the path of the exit wound of the projectile. Bone splinters were also present on the right in the path of the entrance wound, indicating a fracture of the iliac bone.Conclusion This case reminds us about the uncertain trajectory of projectiles in abdominal gunshot wounds and the possible lesions to which one is exposed, and that despite the apparent hemodynamic stability exploratory laparotomy still has its place where medical imaging technology is not available.