Penetrating abdominal trauma is prevalent in most urban settings in the United States; for instance, 25% of trauma cases in Los Angeles are penetrating. Selective nonoperative management is practiced routinely for blunt abdominal trauma, but in most institutions laparotomy is still considered the standard of care for abdominal gunshot wounds. The traditional treatment of these injuries has been exploratory laparotomy for all gunshot wounds to the abdomen and for all stab wounds where peritoneal violation has been proven.