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Its Unreliability in Gunshot Wounds of the Lower Chest and Abdomen

Erwin R. Thal, MD; Robert A. May, MD; David Beesinger, MD

Arch Surg. 1980;115(4):430-433.

Abstract
• The accuracy of peritoneal lavage in patients with gunshot wounds has not been previously reported. A prospective study comprised of 168 patients was designed to determine the reliability of physical examination and peritoneal lavage. Patients sustaining gunshot wounds to the lower chest and abdomen underwent clinical assessment followed up by lavage prior to operation. There was 20.2% false-negative and 15.9% false-positive physical examination results. Of the patients, 25.4% with a negative lavage result had a positive celiotomy. Six of 15 patients with false-negative lavage results had RBC counts less than 1,000/cu mm. Gunshot wounds differ from stab wounds because of the unpredictable trajectory, blast effect, and high likelihood of visceral injury. It can be concluded from this study that because of the inconsistent results of both lavage and physical examination, patients who sustain gunshot wounds are best treated by exploratory celiotomy.

(Arch Surg 115:430-433, 1980)

Author Affiliations
From the Department of Surgery, the University of Texas Health Science Center at Dallas.

Footnotes
Accepted for publication Dec 3, 1979.

Read before the 87th annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1979.

Reprint requests to Department of Surgery, Southwestern Medical School, University of Texas Health Science Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75235.

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