ABSTRACT
CHALLENGING CASE A 23-year-old man sustained a through and through gun shot wound to the left lower abdomen. The patient was mildly hypotensive on arrival to the emergency room, but responded to administration of 2 L of normal saline. The abdominal exam reveals the bullet holes and moderate tenderness. The rectal exam was normal. Chest and abdominal radiographs were normal except for markers at the gunshot wounds, electrolytes and hemoglobin levels were normal. After administration of a second generation cephalosporin and a type and cross for blood, the patient was taken to the operating room for an abdominal exploration. The only injury found was a lateral injury to the mid sigmoid colon. There was minimal stool contamination of the lower abdomen.
