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Adrenal gunshot wound: Laparoscopic approach. Report of a case
Authors:Antonino Agrusa  Giorgio Romano  Giovanni De Vita  Giuseppe Frazzetta  Daniela Chianetta  Giuseppe Di Buono  Gaspare Gulotta
Affiliation:Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy
Abstract:

INTRODUCTION

Although there is no debate that patients with peritonitis or hemodynamic instability should undergo urgent laparotomy after penetrating abdominal injury, it is also clear that certain stable patients may be managed without operation. Controversy persists regarding use of laparoscopy.

PRESENTATION OF CASE

We report a case of gunshot wounds with bullet in left adrenal gland and perirenal subcapsular hematoma. The patients had no signs of peritonitis but in the observation period we noted a significative blood loss, so we performed an exploratory laparoscopy.

DISCUSSION

We found the bullet in adrenal parenchyma. The postoperative period was regular and the patient was discharged without any local or general complication.

CONCLUSION

Although the data are still controversial, the importance of the laparoscopic approach is rapidly increasing also in case of penetrating trauma of the abdomen. This technique assumes both a diagnostic and therapeutic role by reducing the number of negative laparotomies.
Keywords:Laparoscopy   Gunshot wounds   Penetrating abdominal trauma
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