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Thu May 24 00:10:36 BST 2007

I would like to hear your approach to the following case:
Male, 32, gunshot wound to left lateral inferior flank (see picture 01), no
exit wound, arrive ER 20 min. after injury.  BP: 120/75, P: 90, SatO2: 98%,
no cristalloids given.
Abdomen tender in lower quadrants. FAST Neg.  Rectal: normotonic, feces with
little blood.  Pulses: OK.
Abdominopelvic x-ray taken (see picture 02)
CAT Scan shown (pictures 03, 04, 05)

My hospital is a General Hospital and is one of the 3 mayor hospital at my
country.  We manage all trauma patients.

Dr. Fernando Aguilar
General Surgeon
Calderon Guardia General Hospital
San José, Costa Rica
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