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MeSH Review

Wounds, Gunshot

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Disease relevance of Wounds, Gunshot

  • SUMMARY BACKGROUND DATA: Selective nonoperative management is practiced extensively in stab wounds and blunt abdominal trauma, but routine laparotomy is still the standard of care in abdominal gunshot wounds [1].
  • Compared to a cohort of 147 patients admitted to the Midwest Regional Spinal Cord Injury Care System during the time period of the study, subjects were more likely to have paraplegia, incomplete sensory myelopathy, gunshot wounds to the spine and non-surgical spinal stabilization [2].
  • In order to determine whether axonal injury (AI) is a factor in cases of penetrating head injury, the brains of 14 patients who died shortly after sustaining a fatal gunshot wound (GSW) to the head were examined, and the presence of AI determined using immunohistochemical staining for amyloid precursor protein (APP) [3].
  • SETTING: A general community referral center and the local Institute of Forensic Medicine. PARTICIPANTS: A consecutive sample of 20 fresh cadavers (less than 24 hours old), victims of motor vehicle crashes, gunshot wounds, in-hospital deaths [4].
  • Injury to the aorta and inferior vena cava occurred in 9.2% of all penetrating abdominal injuries due to gunshot wounds in our series [5].

High impact information on Wounds, Gunshot

  • CONCLUSION: Selective nonoperative management is a safe method for managing patients with abdominal gunshot wounds in a level 1 trauma center with an in-house trauma team [1].
  • All sustained gunshot wounds to the retro-hepatic vena cava [6].
  • Widespread axonal injury in gunshot wounds to the head using amyloid precursor protein as a marker [3].
  • Gunshot wounds caused 76 per cent of all suicide deaths; 79 per cent of Native and 48 per cent of White suicides had detectable levels of blood alcohol [7].
  • A 28-year-old man was admitted following a massive caffeine overdose and a self inflicted gunshot wound in an apparent suicide attempt [8].

Chemical compound and disease context of Wounds, Gunshot

  • In an effort to define the optimal preventive antibiotics for gunshot wounds to the abdomen, 100 consecutive patients were randomized while in the emergency department to receive either combination ampicillin, amikacin, and clindamycin, combination doxycycline and penicillin, or carbenicillin (Groups I, II, and III, respectively) [9].
  • Frankel scores were used to assess outcome (P < 0.05) and were assessed at admission and at the time of definitive discharge from the Spinal Cord Injury Care System. The hypothesis that methylprednisolone therapy significantly improves functional outcomes in patients with gunshot wound injuries to the spine was rejected [10].
  • The vermilion myomucosal flap for the treatment of oral commissure gunshot wound deformities [11].
  • Interestingly, Action 4 ammunition had been used, leading to an uncommon gunshot wound morphology and extensive backspatter [12].
  • An example of cocaine tolerance in a gunshot wound fatality [13].

Biological context of Wounds, Gunshot

  • Four risk factors were identified: systolic blood pressure < 90 mm Hg, Glasgow Coma Scale score < 9, pulse > 120 beats/min, and high-risk injury (trauma to the chest between the midclavicular lines, abdominal injury with diffuse tenderness, survival of a fatal vehicular crash, ejection from a vehicle, or stab or gunshot wound to the trunk) [14].
  • This chemical test consists of a transfer of the gunpowder residues from the area of a gunshot wound to an adhesive lifter; the residues are then visualized as total nitrite after alkaline hydrolysis by the Modified Griess Test (MGT) [15].

Anatomical context of Wounds, Gunshot


Gene context of Wounds, Gunshot

  • A case of incarcerated traumatic diaphragmatic hernia that occurred 19 years following a gunshot wound of the chest is reported [21].
  • The results indicated that locally applied TNF-alpha benefited the incised and gunshot wound healing [22].
  • These results suggest that, in gunshot wounds, extensive injury to VEC may be the result of the temporary cavity and shock waves produced by high velocity missiles striking the body and causing secretions of endothelin [20].
  • Expression of fibronectin suicidal in gunshot wounds [23].
  • For the 50 consecutive trauma admissions, only two areas of statistical difference were found: more chest films were obtained in the MVC PACS group and more pelvis films were obtained in the gunshot wound pre-PACS group [24].

Analytical, diagnostic and therapeutic context of Wounds, Gunshot


  1. Selective nonoperative management in 1,856 patients with abdominal gunshot wounds: should routine laparotomy still be the standard of care? Velmahos, G.C., Demetriades, D., Toutouzas, K.G., Sarkisyan, G., Chan, L.S., Ishak, R., Alo, K., Vassiliu, P., Murray, J.A., Salim, A., Asensio, J., Belzberg, H., Katkhouda, N., Berne, T.V. Ann. Surg. (2001) [Pubmed]
  2. Function-limiting dysesthetic pain syndrome among traumatic spinal cord injury patients: a cross-sectional study. Davidoff, G., Roth, E., Guarracini, M., Sliwa, J., Yarkony, G. Pain (1987) [Pubmed]
  3. Widespread axonal injury in gunshot wounds to the head using amyloid precursor protein as a marker. Koszyca, B., Blumbergs, P.C., Manavis, J., Wainwright, H., James, R., Gilbert, J., Jones, N., Reilly, P.L. J. Neurotrauma (1998) [Pubmed]
  4. Thoracoscopy vs conventional autopsy of the thorax. A promising perspective. Avrahami, R., Watemberg, S., Hiss, Y. Archives of surgery (Chicago, Ill. : 1960) (1995) [Pubmed]
  5. Reappraisal of low-velocity gunshot wounds of the aorta and inferior vena cava in civilian practice. Mandal, A.K., Boitano, M.A. The Journal of trauma. (1978) [Pubmed]
  6. The atriocaval shunt. Facts and fiction. Burch, J.M., Feliciano, D.V., Mattox, K.L. Ann. Surg. (1988) [Pubmed]
  7. Suicides in Alaska: firearms and alcohol. Hlady, W.G., Middaugh, J.P. American journal of public health. (1988) [Pubmed]
  8. Multiple cardiac arrests following an overdose of caffeine complicated by penetrating trauma. Emohare, O., Ratnam, V. Anaesthesia. (2006) [Pubmed]
  9. Preoperative antibiotics for abdominal gunshot wounds. A prospective, randomized study. Moore, F.A., Moore, E.E., Mill, M.R. Am. J. Surg. (1983) [Pubmed]
  10. Use of methylprednisolone as an adjunct in the management of patients with penetrating spinal cord injury: outcome analysis. Levy, M.L., Gans, W., Wijesinghe, H.S., SooHoo, W.E., Adkins, R.H., Stillerman, C.B. Neurosurgery (1996) [Pubmed]
  11. The vermilion myomucosal flap for the treatment of oral commissure gunshot wound deformities. Fata, J.J. Plast. Reconstr. Surg. (1999) [Pubmed]
  12. Two simultaneous suicidal gunshots to the head with robbed police guns. Padosch, S.A., Dettmeyer, R.B., Schyma, C.W., Schmidt, P.H., Madea, B. Forensic Sci. Int. (2006) [Pubmed]
  13. An example of cocaine tolerance in a gunshot wound fatality. Howell, S.L., Ezell, A.L. Journal of analytical toxicology. (1990) [Pubmed]
  14. Type and crossmatch of the trauma patient. Baker, J.B., Korn, C.S., Robinson, K., Chan, L., Henderson, S.O. The Journal of trauma. (2001) [Pubmed]
  15. Improved method for shooting distance estimation. Part III. Bullet holes in cadavers. Glattstein, B., Zeichner, A., Vinokurov, A., Levin, N., Kugel, C., Hiss, J. J. Forensic Sci. (2000) [Pubmed]
  16. Survival following a gunshot wound of the abdominal aorta and inferior vena cava. Rudich, M.D., Rowland, M.C., Seibel, R.W., Border, J. The Journal of trauma. (1978) [Pubmed]
  17. Renal artery to inferior vena cava fistula following gunshot wound to the abdomen. Kavic, S.M., Atweh, N., Ivy, M.E., Possenti, P.P., Dudrick, S.J. Annals of vascular surgery. (2002) [Pubmed]
  18. Who fired the gun? A casuistic contribution to the differentiation between self-inflicted and non-self-inflicted gunshot wounds. Karger, B., DuChesne, A. Int. J. Legal Med. (1997) [Pubmed]
  19. Unstable cervical spine without spinal cord injury in penetrating neck trauma. Apfelbaum, J.D., Cantrill, S.V., Waldman, N. The American journal of emergency medicine. (2000) [Pubmed]
  20. Injury to vascular endothelial cells and the change of plasma endothelin level in dogs with gunshot wounds. Lai, X., Liu, Y., Wang, J., Li, S., Chen, L., Guan, Z. The Journal of trauma. (1996) [Pubmed]
  21. Incarcerated diaphragmatic hernia: report of an unusual case. DeFrance, J., Bridgman, A.H., Vujic, I., Sethi, G.K. Dis. Colon Rectum (1976) [Pubmed]
  22. In vivo effects of tumor necrosis factor-alpha on incised wound and gunshot wound healing. Fu, X., Tian, H., Hsu, S., Wang, D., Sheng, Z. The Journal of trauma. (1996) [Pubmed]
  23. Expression of fibronectin suicidal in gunshot wounds. Balazic, J., Grajn, A., Kralj, E., Serko, A., Stefanic, B. Forensic Sci. Int. (2005) [Pubmed]
  24. Picture archiving communication system does not decrease the number of radiographs needed to evaluate the trauma patient. Broughton, G., Ilagan, M., Jaffin, J. The Journal of trauma. (1998) [Pubmed]
  25. Cerebral extraction of oxygen, lactate production, and perfusion pressure in gunshot wound to the head: case report. Cruz, J., Zager, E.L., Sinson, G.P., Hoffstad, O.J. The Journal of trauma. (1996) [Pubmed]
  26. Ligation of the suprarenal vena cava after a gunshot wound. Ivy, M.E., Possenti, P., Atweh, N., Sawyer, M., Bryant, G., Caushaj, P. The Journal of trauma. (1998) [Pubmed]
  27. Diagnosis of sudden unexplained death in epilepsy by immunohistochemical staining for prolactin in cerebral vessels. Miller, E.J., Nelson, G.M., Shultz, J.J., Davis, G.G. The American journal of forensic medicine and pathology : official publication of the National Association of Medical Examiners. (2003) [Pubmed]
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