GUNSHOT WOUNDS IN CHILDREN IN THE WESTERN CAPE: A CHANGE IN INCIDENCE WITH A REVIEW OF PROPOSED PREVENTATIVE MEASURES

Mohamed Abdelsalam, Corné de Vos

Division of Pediatric Surgery, Tygerberg Hospital, Stellenbosch University, Cape Town

Abstract

Introduction: Globally abdominal gunshot injuries in children seem rare with reported incidence of 0.55 per 100,000 in the last 10 years. It is more prevalent in war zones, countries with urban violence and undefined legal regulation. In the United States of America (USA) gunshot related injuries is responsible for 20,000 visits to the emergency department and leading cause of death for these children in the USA. In South Africa the incidence seems lower with 163 patients included between 2001-2011 in a study published in 2004.

Case presentation: We present a case series of 5 children that were treated in our department, a level 2 Paediatric trauma unit, in 2024. Age of presentation ranged from 3-11 years, the majority (3:2) being male. All 5

children were injured unintentionally. They were all resuscitated, underwent radiological investigations and were taken for emergency laparotomies, all with positive outcomes.

Conclusion: Abdominal injuries secondary to gunshots can be the cause of severe morbidity and mortality in children. Patient care requires a dedicated trauma center and multidisciplinary team approach. Furthermore, non-operative approaches seem to be a feasible option in dedicated pediatric trauma centers. More research is needed specifically inchildren to prove the efficiency of this approach. We recommend following the preventive strategies suggested by the CDC and WHO coupled with community education and restriction of firearm availability to reduce the incidence of these unintentional GSW injuries in children.