Gunshot wounds continue to occur with an increasing incidence in major United States cities. Gunshot wounds are infrequent in Korea but it tend to increase through the last several years. Civilian gunshot wounds are usually caused by the low
velocity
pistols or rifles, whereas military bullet wounds are caused by the high-velocity type and result in extensive tissue destruction that requires wide and through debridement. For clinical evaluation of gunshot wounds, we analyzed 14 cases who were
operated in the LeeRha General Hospital, between the period from 1990 to 1994. The resutls were as follows; Among the 14 cases, there were 11 males and 3 females. The mean age was 20.4 years. The chief complaints were abdominal pain(5 cases),
bleeding(4
cases), back pain (3 cases) and hypovolemic shock(2 cases). In total 14 cases, 9 cases were caused by air rifles, 4 cases by shotguns and 1 case by handgun, respectively. Injury severity was evaluated according to the ISS, RTS, and ASCOT. Rifle
injured
cases, ISS was 8.01±5.45, RTS was 7.78±0.12 and ASCOT was 0.99±0.01. But shotgun injured cases, ISS was 37.33±17.79, RTS was 5.01±3.55 and ASCOT was 0.63±0.48. In 14 cases, abdomen & pelvis injured cases were 5 cases(small bowel
perforation:
1
liver injury: 1 mesentery tearing: 1, retroperitoneal hematoma & bladder rupture: 1, pelvis crushing injury & spinal cord injury: 1). Head & neck injured cases were 2 cases (intracranial hemorrhage: 1, skull fracture: 1). Thoracic injured cases
were 2
cases(hemopneumothorax: 2). Upper and lower extremity injured cases were 2 cases(wrist injury: 1, femur fracture: 1). Great vessel injured cases were 2 cases(inferior vena cava: 1 femoral vein injury: 1). 12 cases were performed operation and 2
cases
were not performed. In 14 cases, 2 cases were died, All the cases who died were injured by shotgun for killing. Overall mortality was 16.7%(2 cases).
In conclusion, most of gunshot injuries in Korea were not severe due to injured by low velocity bullet. So more aggressive approaches were required for improvement of prognosis. Shotgun wounds were tend to more severely injured than the gunshot
wounds.
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