Extraction of a foreign body due to a penetrating wound in the buttock region by a firearm ultrasound-guided: a case report
Keywords:Firearm, Ultrasound, Foreign body, Extraction, Penetrating wound
The use of ultrasound as a diagnostic and therapeutic support method for patients with penetrating gunshot wounds must be individualized in patients who require the removal of the foreign body. We report the case of a male in the fourth decade of life with a penetrating wound in the gluteal region on the left side of approximately 0.5 cm by 0.5 cm. Initially, stabilization was performed according to ATLS and later the patient was left in charge of general surgery. Doppler ultrasound was performed as the first and only imaging study to assess a possible vascular condition, which was negative. Due to the location of the projectile added to the medical-legal need of the patient to obtain the projectile, it was extracted with the help of an ultrasound-guided radiologist without the need to make an incision, since the bullet was extracted through the entrance hole. The reported literature mentions that there are key points, mentioned later in this article, for the extraction of bullets by firearm. Evidence for the use of ultrasound is limited but it should be kept in mind that ultrasound can be a useful diagnostic and therapeutic tool in removal of foreign bodies.
Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler A, Orgill DP et al. The SCARE 2018 Statement: Updating Consensus Surgical Case Report (SCARE) Guidelines. Int J Surg. 2018;60:132-6.
Rice DP, MacKenzie EJ, Jones AS. Cost of Injury in the United States: A Report to Congress. Institute for Health & Aging, University of California and Injury Prevention Center, The Johns Hopkins University. 1989.
Navsaria PH, Nicol AJ, Edu S. Selective nonoperative management in 1106 patients with abdominal gunshot wounds: conclusions on safety, efficacy, and the role of selective CT imaging in a prospective single-center study. Ann Surg. 2015;261:760.
Martin MJ, Brown CVR, Shatz DV. Evaluation and management of abdominal gunshot wounds: A Western Trauma Association critical decisions algorithm. J Trauma Acute Care Surg. 2019;87:1220.
Søreide K. Epidemiology of major trauma. Br J Surg. 2009;96:697.
Demetriades D, Murray J, Sinz B. Epidemiology of major trauma and trauma deaths in Los Angeles County. J Am Coll Surg. 1998;187:373.
Teixeira PG, Inaba K, Salim A. Preventable morbidity at a mature trauma center. Arch Surg. 2009;144:536.
Health Secretary. Epidemiological and Statistical Panorama of Mortality from Causes Subject to Epidemiological Surveillance in Mexico, 2017. Mexico: Ministry of Health. 2019. Available at: https://www.gob.mx/cms/uploads/attachment/file/498153/YEARBOOK_MORTALITY_201. Accessed on 25 March, 2023.
Dienstknecht T. Indications for bullet removal: overview of the literature, and clinical practice guidelines for European trauma surgeons. Eur J Trauma Emerg Surg. 2012;38:89-93.
Veselko M, Trobec R. Intraoperative localization of retained metallic fragments in missile wounds. J Trauma. 2000;49(6):1052-8.
Schlager D, Lazzareschi G, Whitten D. A prospective study of ultrasonography in the ED by emergency physicians. Am J Emerg Marl. 1994;12:185-9.
Das J, Khanna S, Kumar S, Khan AZ, Mehta Y. Use of point of care ultrasound for removal of foreign body: "Early screening of the neighborhood is the key". J Anaesthesiol Clin Pharmacol. 2016;32(3):415-6.
Schlager D. Safety of Imaging Exploding Bullets with Ultrasound. Am J Emerg Marl. 1996;28-2.
Schlager D. Ultrasound for the detection of foreign bodies. Am J Emerg Marl. 1991;20:189-91.