It’s the kind of trouble trauma surgeons see often, and they have learned though bitter experience how best to deal with it.

The first priority is to operate to stop the bleeding and control any contamination that might arise from something like a torn intestine. Afterward, hospital staff members wheel the patient from the operating room straight to intensive care, often with the abdomen still open.

The next steps are to seal small blood vessels that may be torn and then to operate, if necessary, to permanently repair damage.

A gunshot victim may undergo two to 10 operations, said Dr. Jeremy Cannon, a trauma surgeon at the University of Pennsylvania, and may remain in the hospital anywhere from days to several months.