| Abstract [eng] |
Abdominal gunshot injuries remain among the most complex forms of trauma due to their broad spectrum of injury patterns, high risk of complications, and the need for rapid selection of an appropriate treatment strategy. Although laparotomy was long considered the standard approach, increasing attention has been given in recent decades to selective non-operative management (SNOM) in carefully selected patients. The aim of this work was to conduct a systematic analysis of recent scientific literature on the non-operative management of abdominal gunshot injuries, to evaluate the advantages and limitations of this approach, and to provide recommendations for its clinical application. The literature analyzed in this thesis addressed the epidemiology and pathophysiology of abdominal gunshot injuries, the limitations of traditional surgical management, SNOM selection criteria, diagnostic strategies, treatment outcomes, complications, and clinical protocols. The analysis showed that selective non-operative management may be safe and effective in hemodynamically stable patients without signs of peritonitis, provided that reliable repeated clinical examinations, appropriate use of computed tomography, and the possibility of immediate treatment escalation are ensured. The greatest risk associated with SNOM is delayed diagnosis of hollow viscus injuries; therefore, the success of this approach directly depends on appropriate patient selection and structured clinical monitoring. The analysis demonstrated that SNOM is an important component of abdominal gunshot injury management; however, its application must remain strictly selective. The use of this approach may reduce the burden of unnecessary laparotomies, postoperative complications, and healthcare resource utilization, while maintaining patient safety. |
