J Trauma
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Selective management of 465 patients with stab wounds limited to the posterior abdomen is reviewed. Celiotomy was based primarily on clinical findings. Tenderness not localized to the area of injury and absent or rare bowel sounds best identified patients with serious injuries. ⋯ Six per cent had "nonessential' celiotomies. The overall morbidity was 11%, and mortality rate, 1.1%. Selective management of posterior abdominal stab wounds is a prudent and reliable approach.
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A case of shotgun pellet embolization to the middle cerebral artery is presented. Embolization occurred approximately 36 hours following successful resuscitation of blood pressure, respirations, and neurologic function in a 21-year-old man who had sustained a massive chest wound. ⋯ In all cases of shotgun trauma to the chest cerebral embolization of pellets should be considered at any sign of neurologic change and skull films obtained. Surgical intervention is necessary before cerebral infarction.