Stable Patients with Gunshot Wounds to the Torso Can Be Discharged Within 24 Hours

Protocols no longer mandate immediate exploratory laparotomy for hemodynamically stable patients with gunshot wounds to the abdomen without peritoneal signs. It is not clear, however, how long such patients require observation to detect delayed evidence of hollow viscus injury. Researchers prospectively studied patients aged ≥16 years with gunshot wounds to the torso (defined as the region extending from the fifth intercostal space in the thorax to the perineum) who presented to a level I trauma center in Los Angeles from 2009 to 2011. The mean Injury Severity Score was 13.8.

Of 245 patients, 115 (47%) underwent immediate surgery on the basis of clinical findings (peritonitis, hypotension, evisceration, unevaluable) and 130 (53%) underwent c…