PT - JOURNAL ARTICLE AU - Salma Khan AU - Amyn Pardhan AU - Tufail Bawa AU - Naveed Haroon TI - Conservative management of an abdominal gunshot injury with a peritoneal breach: wisdom or absurdity? AID - 10.1136/bcr-2013-201593 DP - 2013 Nov 22 TA - BMJ Case Reports PG - bcr2013201593 VI - 2013 4099 - http://casereports.bmj.com/content/2013/bcr-2013-201593.short 4100 - http://casereports.bmj.com/content/2013/bcr-2013-201593.full AB - Surgical exploration has been the standard of care for abdominal gunshot injuries. The authors report a case of a 28-year-old man who sustained a transabdominal gunshot injury, which entered the anterior abdominal wall and exited adjacent to the T12 vertebra posteriorly with a tangential trajectory. On presentation, the patient was haemodynamically stable with no peritoneal signs. Based on trajectory of the bullet, intra-abdominal injury was suspected. Therefore a CT scan abdomen with intravenous and rectal contrast was performed. The CT scan revealed no extravasation of the rectal contrast but showed free air specks behind the descending colon. Delayed renal images of the left ureter were also normal. Based on the clinical findings, the patient was managed non-operatively with nothing per oral, intravenous antibiotics and frequent abdominal assessments. He made an uneventful recovery without necessitating laparotomy.