Selective conservative management of penetrating hollow viscus injuries: a report of three cases.

In this manuscript, we report three cases of penetrating abdominal injury: one with pellet injury, one with pellet injury after a bomb explosion and one with gunshot injury. All three patients were successfully managed nonoperatively. A 30-year-old male was admitted to our trauma and emergency service with a pellet injury. His physical examination revealed multiple pellet injuries in the left upper abdominal quadrant, left hemithorax, left axilla, dorsal side of the abdomen, left upper extremity, and left gluteus. The second case was a 16-year-old male admitted with a shrapnel injury after a bomb explosion. His physical examination revealed multiple shrapnel injuries in the thoracal and abdominal regions, extremities and left eye. The third case was a 30-year-old male admitted with gunshot and stab wound injury. He had multiple stab wound injuries in both lower extremities and a gunshot wound in the left posterosuperior hemithorax, left upper abdomen and left dorsolumbar region. All these cases were treated non-operatively. We advocate a policy of selective conservatism based on careful initial and subsequent serial clinical examinations and imaging techniques as needed.