Civilian abdominal gunshot wounds in Lagos

This prospective study of 78 patients who sustained abdominal gunshot wounds was performed to evaluate the pattern of injuries, treatment outcome and the role of selective conservative management. Three (3.8%) patients died before laparotomy. Four (5.1%) patients with superficial wounds were managed by local wound care. Fourteen (18%) patients who had equivocal or minimal abdominal signs were selected for conservative management. Laparotomy was performed in 57 (73.1%) patients who presented with an acute abdomen. The commonly injured organs were the small bowel (56.1%), colon (38.6%), liver (22.8%) and stomach (19.3%). Prolonged injury to arrival and surgical intervention time were contributing factors to the high incidence of sepsis (63.2%) and mortality (22.8%) after laparotomy. Two patients selected for conservative management required delayed laparotomy, one of which was negative. A 10-fold increase in prevalence of abdominal gunshot wounds has occurred in our institution in the 1990s. Selective conservative management is feasible without the use of expensive investigations.