Objective:

To determine the usefulness of computed tomography (CT) in the selection of patients with abdominal gunshot wounds for nonoperative management.

Materials and methods:

An observational study was carried out by reviewing the clinical records of 62 patients older than 15 years with abdominal gunshot wounds without indication for emergent surgery who underwent abdominal CT with triple contrast.

Results:

We analyzed the records of 276 patients with abdominal gunshot wounds, of which 214 underwent emergent surgery and 62 underwent CT. CT indicated surgery in 14 patients, 12 were therapeutic laparotomies and in two cases laparotomy was not therapeutic. In the remaining 48 patients, CT indicated non-operative management. However, in two of these therapeutic early laparotomies were performed; three of the 46 patients who underwent non-operative management had to be submitted to subsequent surgery, but at laparotomy no visceral lesion was found.

An overall rate of 10.1% of non-therapeutic laparotomies was encountered and successful non-operative management was registered in 69.3%. The sensitivity of CT was 85.7% (95% CI: 63.8% -100%), specificity 95.8% (95% CI: 89.1% -100%), positive predictive value 85.7 % (95% CI: 63.8% -100%), negative predictive value 95.8% (95% CI: 89.1% -100%), LR + 21.5 and LR- 0.15

Conclusion:

Abdominal CT is a safe and useful method for the selection of patients with abdominal gunshot wounds for non-operative management.

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