Gunshot wounds to the buttocks.

Twenty patients sustaining gunshot wounds (GSW) to the buttocks (including one shotgun wound) were treated at two affiliated institutions during the last 5 years. Male patients predominated nine to one. Fifteen patients with extraperitoneal injuries had a benign course. One underwent negative exploratory laparotomy based upon positive physical findings. The remaining five patients had clinical abdominal findings consistent with severe intra-abdominal injuries (four organs per patient). Although the morbidity was high, there was no mortality in this series. Careful analysis of a bullet's trajectory will allow detection of a possible intraabdominal component of this type of injury, mandating early surgical management.