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To better determine the safety of nonoperative management by relying on computed tomography (CT) imaging in patients with abdominal gunshot wounds, researchers prospectively studied 1106 gunshot victims admitted to a trauma center in South Africa between 2004 and 2009. All patients were hemodynamically stable, had reliable physical examinations, and had no peritoneal signs. CT imaging was routinely performed in patients with right upper quadrant or thoracoabdominal projectile trajectories, hematuria, or projectile trajectory concerns by the attending surgeon.
About 25% of patients (272) were managed nonoperatively with continuous hemodynamic monitoring, serial physical examinations, and hemoglobin measurements every 4 hours. Of these patient…