Civilian low velocity gunshot wounds of the liver
Leppäniemi, A.K.; Salo, J.A.; Haapiainen, R.K.
European Journal of Surgery 160(12): 663-668
1994
ISSN/ISBN: 1102-4151 PMID: 7888466 Document Number: 432730
Objective: To report our experience in the management of hepatic gunshot wounds. Design: Retrospective study of medical records. Setting: University department of surgery, Finland. Subjects: 38 patients admitted with hepatic gunshot wounds confirmed at operation. Interventions: Laparotomy in all cases. Main outcome measures: Morbidity and mortality. Results: Of the 35 low velocity bullet wounds of the liver, 23 (66%) were severe, but 34 (97%) could be managed with simple operative techniques. Two of the three shotgun injuries were at point-blank range, and one required lobectomy. Four patients (11%) died, and in all cases haemorrhage from associated cardiovascular injuries was a major contributing factor. Postoperative morbidity after bullet wounds was 57%, including two local hepatic complications. Conclusions: Simple operative repairs are sufficient and safe in most patients with low velocity bullet wounds of the liver. Associated injuries are the main cause of postoperative mortality and morbidity. Point-blank shotgun injuries involving the liver are not necessarily fatal.