{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:21:38Z","timestamp":1768432898178,"version":"3.49.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":91,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Non-operative management and minimally invasive surgery reduce the burden of negative laparotomies in patients with penetrating gunshot wounds (GSW). Careful patient selection is key. Although challenging, in experienced hands laparoscopic exploration of the retroperitoneal space can be carried out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 38year old man was brought to the emergency room after sustaining a GSW to his right groin. Due to evidence of intoxication, clinical picture was unreliable, although the patient was hemodynamically stable and there were no signs of peritonitis. Furthermore, the presence of retained bullet fragments created significant artifact on imaging. Clinical and radiological uncertainty urged us to proceed with laparoscopic exploration. Following mobilization, the ascending colon wall was fully inspected and no injury was identified. The pelvic fracture was managed non-operatively. After an uneventful hospital course, the patient was discharged home in stable condition and outpatient follow up was re-assuring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Avoiding morbidity from missed colonic injury is important, particularly in patients with unclear clinical and radiological findings, that were present in our case. Non-operative management by serial examination and minimally invasive surgical techniques are considered an alternative to the classical exploratory laparotomy approach. Furthermore, utilization of laparoscopy in retroperitoneal injury has gained much attention in the recent years particularly in well-established centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Laparoscopic exploration is a safe and effective surgical approach in patients who have sustained GSW to the abdomen and to the retroperitoneal space. However, it requires careful patient selection and surgical expertise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.105863","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T11:37:22Z","timestamp":1617709042000},"page":"105863","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic exploration of the retroperitoneum in a gunshot victim"],"prefix":"10.1097","volume":"82","author":[{"given":"Hadeel Ayman","family":"Helmi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raed Ibrahim","family":"Alshalfan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim Tawfiq","family":"Albabtain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-21-20260114","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/0002-9610(80)90130-0","article-title":"Mandatory laparotomy for gunshot wounds penetrating the abdomen","volume":"140","author":"Moore","year":"1980","journal-title":"Am. J. Surg"},{"key":"R2-21-20260114","first-page":"721","article-title":"Practice management guidelines for selective non- operative management of penetrating abdominal trauma","volume":"68","author":"Como","year":"2010","journal-title":"J. Trauma"},{"key":"R3-21-20260114","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s00268-012-1790-y","article-title":"Role of laparoscopy in penetrating abdominal trauma: a systematic review","volume":"37","author":"O\u2019Malley","year":"2013","journal-title":"World J. Surg"},{"key":"R4-21-20260114","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.ijscr.2013.12.020","article-title":"Adrenal gunshot wound: laparoscopic approach. Report of a case","volume":"5","author":"Agrusa","year":"2014","journal-title":"Int. J. Surg. Case Rep"},{"key":"R5-21-20260114","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4103\/jmas.JMAS_199_17","article-title":"Laparoscopic management of retroperitoneal injuries from penetrating abdominal trauma in haemodynamically stable patients","volume":"15","author":"Koto","year":"2019","journal-title":"J. Minim. Access Surg"},{"key":"R6-21-20260114","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus Surgical Case Report (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R7-21-20260114","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1757-7241-17-19","article-title":"Penetrating abdominal injuries: management controversies","volume":"17","author":"Butt","year":"2009","journal-title":"Scand. J. Trauma Resusc. Emerg. Med"},{"key":"R8-21-20260114","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/S0002-9610(97)00098-6","article-title":"A selective approach to the management of Gunshot wounds to the back","volume":"174","author":"Velmahos","year":"1997","journal-title":"Am. J. Surg"},{"key":"R9-21-20260114","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.tcr.2015.10.008","article-title":"Patterns of retroperitoneal trauma following gunshot violence: a case series","volume":"1","author":"Onwochei","year":"2015","journal-title":"Trauma Case Rep"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261221003655?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261221003655?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2021.105863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:02:41Z","timestamp":1768395761000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2021.105863"}},"subtitle":["A case report\u2606"],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":9,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2021.105863","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}