Civilian low velocity gunshot wounds of the liver.

OBJECTIVE

To report our experience in the management of hepatic gunshot wounds.

DESIGN

Retrospective study of medical records.

SETTING

University department of surgery, Finland.

SUBJECTS

38 patients admitted with hepatic gunshot wounds confirmed at operation.

INTERVENTIONS

Laparotomy in all cases.

MAIN OUTCOME MEASURES

Morbidity and mortality.

RESULTS

Of the 35 low velocity bullet wounds of the liver, 23 (66%) were severe, but 34 (97%) could be managed with simple operative techniques. Two of the three shotgun injuries were at point-blank range, and one required lobectomy. Four patients (11%) died, and in all cases haemorrhage from associated cardiovascular injuries was a major contributing factor. Postoperative morbidity after bullet wounds was 57%, including two local hepatic complications.

CONCLUSIONS

Simple operative repairs are sufficient and safe in most patients with low velocity bullet wounds of the liver. Associated injuries are the main cause of postoperative mortality and morbidity. Point-blank shotgun injuries involving the liver are not necessarily fatal.