A clinical review of shotgun wounds to the chest and abdomen.

Since a controversy exists over whether patients with truncal shotgun wounds should have selective or mandatory exploration, we reviewed the records of 1,222 patients with truncal missle wounds treated over a six year period at our institution. Based upon a detailed review of 42 of these patients, who had sustained shotgun wounds, we believe that not all patients with truncal shotgun wounds require mandatory surgical exploration. That, in fact, a subgroup of patients can be identified who can be safely managed nonoperatively, based upon the pattern of the injury and the clinical status of the patient at the time of arrival to the emergency room.