Abdominal trauma revisited

This article retrospectively reviews 258 consecutive abdominal trauma admissions who required laparotomy from July 1985 to June 1989 at a level one urban trauma center to define the population at risk, the patterns of injury, and the resulting morbidity and mortality. The findings were compared with a series of 252 abdominal trauma patients reported in 1974 by one of the authors. The majority of injuries in this series were gunshot wounds (GSWs) (47%), followed by stab wounds (SWs) (43%) and blunt abdominal trauma (10%). Males predominated, and 96% of patients were black. Major vascular system injury was the primary cause of death. Prompt evaluation, resuscitation, and operative intervention are mandatory in all abdominal GSW patients. More than half of those patients with major vascular system injury did not present in shock but had a high associated mortality.