ISPUB.COM The Internet Journal of Surgery Volume 16 Number 2 1 of 8 Gunshot Injuries In A North Eastern Nigerian Tertiary Hospital E Ojo, A Ibrahim, S Alabi, S Obiano Citation E Ojo, A Ibrahim, S Alabi, S Obiano. Gunshot Injuries In A North Eastern Nigerian Tertiary Hospital. The Internet Journal of Surgery. 2007 Volume 16 Number 2. Abstract Background: Worldwide gunshot injuries are causes of considerable burden to patients and the society. Such burdens are not limited to huge financial demands but may lead to outright victims' permanent disability or demise. Objective: To determine the incidence, causes, pattern and outcome of gunshot injury in patients presenting to a tertiary Nigerian hospital. Design: A five year retrospective study. Method: The analyzed data were retrieved from patients' registers in the wards and operating theatre and from case notes. Outcome: There were substantial morbidity and mortality despite the preponderance of low velocity missiles necessitating admission in 73.9% of patients. Intentional injuries occurred in 91 (76.5%) patients and were caused by armed robbery in 78 (65.5%) and by assault in 10 (8.4%) patients while 28 (23.5%) patients had accidental discharges. The lower limbs (45 patients; 37.8%), the upper limbs (21; 17.6%) and the abdomen (13; 10.9%) were the frequently involved sites while gluteal region (2; 1.7%) and perineum (1; 0.8%) were the least affected sites. Multiple-site injuries were seen in 11 (9.2%) patients. Duration of hospitalisation ranged from one to 183 days (mean: 29.9 days). Most of the admissions were a result of long bone fractures (32 patients; 26.9%), abdominal injuries (12; 10.1%) and major soft-tissue injuries (9; 7.6%). Long-bone fractures were also responsible for the longest hospital duration while patients admitted on account of long distances had the shortest stay. Wound infection was the most frequent noted complication and there was a mortality rate of 3.36%. Conclusion: A concerted effort at preventing local proliferation of firearm use and prevention of further regional and sub-regional influx of firearms from wars through sustainable peace initiatives and surveillance systems is imperative. INTRODUCTION Gunshot injuries result from the effect of a bullet or projectiles emanating from the use of firearms. There is equally a considerable contribution to the wound process by tissue fragments. 1 Gunshot injuries are on the increase globally and have wide regional variations 2 ; they are a known cause of high morbidity and mortality and have become the leading external cause of non-natural deaths in some parts of the African continent. 3 Firearm injuries are associated with substantial emotional, physical and financial burden causing an enormous human toll and imposing huge costs on the society despite outcomes that could be lethal. 4 This is a result of the unpredictability of gunshot injuries with potentials for causing damages through wide mechanisms. Direct impact of gunshot injuries causes laceration, crushing, abrasion, fragmentation of bone and tissue along the missile tract. These may lead to an instant death through exsanguination from haemorrhagic shock or through hypoxia from cardiac tamponade, pneumothorax or damage to vital systems like the central nervous system. Remote tissue damage may also occur through production of temporary cavitations and generation of high-pressure shock in a closed compartment. Firearm injuries are increasingly seen in many developing countries 5 which has been attributed to spates of communal and ethnic clashes, political violence and armed robberies 6 . Wars within and around the West African sub-region have also encouraged easy access to sophisticated and locally manufactured firearms leading to a high incidence of