Transaxial gunshot injuries

J Trauma. 1996 Sep;41(3):460-1. doi: 10.1097/00005373-199609000-00011.


Objective: To define the clinical characteristics of gunshot injuries across the truncal midline (transaxial injuries).

Design: A retrospective case-control study

Materials and methods: Analysis of a consecutive series of 223 patients with gunshot injuries to the torso treated at one trauma center. Sixty-three patients with transaxial injuries were compared to 148 patients with unilateral bullet trajectories.

Main results: The incidence of cardiac (8%), vascular (17%), and spinal (29%) injuries and the mortality rate (29%) were significantly higher among the 63 patients with transaxial injuries compared with 148 patients with unilateral injuries. Initial operative access to the wrong visceral cavity (10%), missed injuries (14%), and early reoperations (19%) were also more common in the transaxial group.

Conclusions: A transaxial bullet trajectory identifies a distinct injury pattern associated with a high incidence of major visceral damage, intraoperative misadventures, and very high mortality.

MeSH terms

  • Abdominal Injuries* / mortality
  • Abdominal Injuries* / surgery
  • Adolescent
  • Adult
  • Aged
  • Case-Control Studies
  • Child
  • Female
  • Humans
  • Israel / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thoracic Injuries* / mortality
  • Thoracic Injuries* / surgery
  • Wounds, Gunshot* / mortality
  • Wounds, Gunshot* / surgery