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10 "Gunshot"
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Original Article
Injuries from blank cartridge shots in suicide attempts within the South Korean military: a case series of five patients
Jeong Il Joo, Changsin Lee, Kyungwon Lee
J Trauma Inj. 2024;37(4):262-267.   Published online December 4, 2024
DOI: https://doi.org/10.20408/jti.2024.0037
  • 531 View
  • 27 Download
AbstractAbstract PDF
Purpose
Blank cartridges are designed to produce the sound and gas flare of a gunshot without firing a bullet. However, blank cartridge shots (BCS) can still cause injuries ranging from minor to life-threatening. Within the South Korean military, most BCS-related injuries have occurred during suicide attempts. This study documents a case series of patients who sustained injuries from BCS during such attempts.
Methods
We examined the medical records of Korean soldiers at a military trauma center between April 2022 and April 2024 who had sustained injuries from BCS during suicide attempts. The analyzed data included general characteristics, injury site, surgical and psychiatric interventions, and length of hospitalization.
Results
The case series included five patients between 19 and 20 years old (mean age, 19.6±0.55 years). Four of these patients sustained self-inflicted gunshot wounds to the submandibular area, while one targeted the right temporal area. Although initial vital signs and laboratory findings were unremarkable, computed tomography scans revealed injuries from projectile gas and gunpowder, including burns, subcutaneous emphysema, and major structural damage. Cases 1 and 2 required emergency surgery for foreign body removal and debridement. The average length of hospitalization was 35.2±12.11 days. Patients were first admitted to the trauma surgery department for BCS injury management, and then transferred to the psychiatry department for emotional support. The average stay was 15.6±15.87 days in trauma surgery and 19.6±14.99 days in psychiatry.
Conclusions
This study highlights the consequences of BCS from suicide attempts in the South Korean military and provides valuable insights for medical personnel who may encounter patients with BCS injuries.
Summary
Case Reports
A starry night: a case report of severe liver injury due to a close-range shotgun blast in Argentina
Rodrigo Antonio Gasque, José Gabriel Cervantes, Magalí Chahdi Beltrame, Marcelo Enrique Lenz-Virreira, Emilio Gastón Quiñonez
J Trauma Inj. 2024;37(4):286-290.   Published online October 21, 2024
DOI: https://doi.org/10.20408/jti.2024.0036
  • 795 View
  • 36 Download
AbstractAbstract PDF
This report presents the case of a 20-year-old man who sustained a severe liver injury from a close-range shotgun blast. A prompt medical intervention, including damage control exploratory laparotomy and surgical debridement, was undertaken due to the extent of liver damage. Despite challenges such as a nondirected biliary fistula and extensive liver parenchymal injury, comprehensive surgical management led to successful treatment. Postoperative complications, including biloma and fungal infection, were managed appropriately, highlighting the importance of vigilant follow-up care. The case underscores the complexity of managing severe liver trauma and emphasizes the evolving role of trauma damage control strategies and minimally invasive procedures in achieving favorable outcomes.
Summary
Penetrating cardiac injury resulting in a bullet embolus: a case report
Sammy Shihadeh, Anwar Khan, Kristen Walker, Ali Al-Rawi, Alfredo Cordova
J Trauma Inj. 2024;37(3):233-237.   Published online September 3, 2024
DOI: https://doi.org/10.20408/jti.2024.0018
  • 976 View
  • 38 Download
AbstractAbstract PDF
Bullet embolism is a potential complication of a gunshot wound, especially with a low-velocity missile. This is because the trajectory of the low-velocity bullet can be significantly slowed as it passes through tissue. An unusual form of travel can occur in which the bullet enters the vasculature but does not have enough kinetic energy to create a through-and-through wound, leading it to remain inside the vasculature. Once inside the vasculature, the bullet could migrate to different parts of the body, potentially causing complications such as ischemia, becoming a source of thromboembolism, or functioning as a nidus for infection. The management of a bullet embolism varies from case to case, as each patient with this issue has a unique body habitus that can result in infinite possibilities of the trajectory and destination of the bullet embolus. Additional damage to surrounding vasculature or tissue can occur, as well as embolization of the bullet to critical areas of the body. Here we present the case of a 72-year-old man who had a self-inflicted gunshot wound to the chest with a low-velocity bullet, which penetrated the right atrium of the heart. It traveled into the venous vasculature through the right atrium, into the inferior vena cava, and eventually settled in the right internal iliac vein. He refused further intervention and management after initial workup and resuscitation.
Summary
Penetrating right ventricular injury following a single gunshot to the left flank in Iraq: a case report
Zryan Salar Majeed, Yad N. Othman, Razhan K. Ali
J Trauma Inj. 2023;36(3):253-257.   Published online April 19, 2023
DOI: https://doi.org/10.20408/jti.2022.0073
  • 2,036 View
  • 49 Download
  • 1 Citations
AbstractAbstract PDF
A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.
Summary

Citations

Citations to this article as recorded by  
  • Management of cardiac trauma and penetrating cardiac injuries with severe hemorrhagic shock: a 5-year experience
    Tran Thuc Khang
    Journal of Trauma and Injury.2024; 37(4): 268.     CrossRef
Experience and successful treatment of craniocerebral gunshot injury at a regional trauma center in Korea: a case report and literature review
Mahnjeong Ha, Seunghan Yu, Jung Hwan Lee, Byung Chul Kim, Hyuk Jin Choi
J Trauma Inj. 2022;35(4):277-281.   Published online November 22, 2022
DOI: https://doi.org/10.20408/jti.2022.0057
  • 2,750 View
  • 71 Download
  • 1 Citations
AbstractAbstract PDF
Craniocerebral gunshot injuries is gradually increasing in the civilian population with a worse prognosis than closed head trauma. We experienced a case of craniocerebral gunshot injury which a bullet penetrating from the submandibular area into the clivus of a patient. The patient did not show any symptom. However, serial laboratory findings showed an increase in blood lead level. We removed foreign bodies without any problems using an endoscopic transnasal transclival approach. Due to the extremely low frequency, guidelines for definitive management of gunshot injuries have not been presented in Korea yet. We introduce our surgical experience of a craniocerebral gunshot injury with an unusual approach for removing intracranial foreign bodies.
Summary

Citations

Citations to this article as recorded by  
  • Endoscopic Endonasal Removal of a Bullet Lodged in the Anterior Lower Clivus: A Case Report
    Saemchan Jang, Ki Seong Eom
    Korean Journal of Neurotrauma.2024; 20(2): 108.     CrossRef
Management of a Retained Bullet in the Corpora Cavernosa after a Civilian Gunshot Injury: A Rare Scenario
Ali Abdel Raheem, Ibrahim Alowidah, Mohamed Almousa, Mohamed Alturki
J Trauma Inj. 2020;33(4):275-278.   Published online June 2, 2020
DOI: https://doi.org/10.20408/jti.2020.007
  • 4,564 View
  • 93 Download
  • 1 Citations
AbstractAbstract PDF

A 24-year-old man presented to King Saud Medical City emergency department with a retained bullet in his penis following a civilian exchange of gunfire. After an initial assessment, the patient was taken to the operating room. Penile exploration was performed, the bullet was extracted successfully, and the corpora cavernosa were repaired properly. A 6-week follow-up showed full healing with preservation of erectile function. Immediate surgical intervention is mandatory as the primary treatment for penile gunshot injury to ensure proper anatomical and functional recovery.

Summary

Citations

Citations to this article as recorded by  
  • Retained Bullet in the Penis
    Morgan Eudy, Natalie Nowak
    Cureus.2021;[Epub]     CrossRef
Experience of Penetrating Gunshot Wound on Head in Korea
Hong Rye Kim, Seung Je Go, Young Hoon Sul, Jin Bong Ye, Jin Young Lee, Jung Hee Choi, Seoung Myoung Choi, Yook Kim, Su Young Yoon
J Trauma Inj. 2018;31(2):82-86.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.82
  • 8,403 View
  • 75 Download
  • 1 Citations
AbstractAbstract PDF

Craniocerebral gunshot injuries (CGIs) are extremely seldom happened in Korea because possession of individual firearm is illegal. So, CGIs are rarely encountered by Korean neurosurgeons or Korean trauma surgeons, though in other developing countries or Unites states of America their cases are indefatigably increasing. Management goal should focus on early aggressive, vigorous resuscitation. The treatments consist of immediate life salvage through correction of coagulopathy, intracranial decompression, prevention of infection and preservation of nervous tissue. There have been few studies involving penetrating CGIs in Korea. Here we present a case of penetrating gunshot wound in Korea. We present a 58-year-old man who was unintentionally shot by his colleague with a shotgun. The patients underwent computed tomography (CT) for assessment of intracranial injury. The bullet passed through the left parietal bone and right lateral ventricle and exited through the posterior auricular right temporal bone. After CT scan, he arrested and the cardiopulmonary resuscitation was conducted immediately. But we were unable to resuscitate him. This case report underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision. Physicians should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators.

Summary

Citations

Citations to this article as recorded by  
  • Civilian penetrating traumatic brain injury: A 5-year single-center experience
    Omid Yousefi, Pouria Azami, Roham Borazjani, Amin Niakan, Mahnaz Yadollahi, Hosseinali Khalili
    Surgical Neurology International.2023; 14: 28.     CrossRef
Long-term Fistula Formation Due to Retained Bullet in Lumbar Spine after Gunshot Injury
Se Il Jeon, Soo Bin Im, Je Hoon Jeong, Jang Gyu Cha
J Trauma Inj. 2017;30(2):51-54.   Published online June 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.2.51
  • 1,996 View
  • 15 Download
AbstractAbstract PDF
We here report a case of long-term fistula formation due to bullet retention for 30 years in the lumbar spine after a gunshot injury, and describe its treatment. A 62-year-old male visited our hospital due to pus-like discharge from his left flank. The discharge had been present for 30 years, since his recovery from an abdominal gunshot injury. A spine radiography showed radiopaque material in the body of the third lumbar vertebra. Foreign body was removed using an anterolateral retroperitoneal approach. The postoperative course was uneventful. The patient was discharged 7 days after the operation and was followed-up for 8 months, during which time, the fistula did not reoccur. A bullet retained long term in the vertebral body may cause obstinate osteomyelitis and fistula formation. A fistula caused by a foreign body in the spine can be effectively treated by surgical removal.
Summary
A Gunshot Wounds to the Cervical Spine and the Cervical Spinal Cord: A Case Report
Sung Hwa Paeng
J Korean Soc Traumatol. 2012;25(2):57-62.
  • 3,015 View
  • 6 Download
AbstractAbstract PDF
Gunshot wounds are rare in Korea, but they have tended to increase recently. We experienced an interesting case of penetrating gunshot injuries to the cervical spine with migration the fragments of the bullet within the dural sac of the cervical spine,so discuss the pathomechanics, treatment and complications of gunshot wounds to the spine and present a review of the literature. A 38-year-old man who had tried to commit suicide with a gun was admitted to our hospital with a penetrating injury to the anterior neck. the patient had quadriplegia. A Computed tomography (CT) scan and 3-dimensional CT of the spine showed destruction of the left lateral mass and lamina of the 5th cervical vertebra; the bullet and fragments were found at the level of the 5th cervical vertebra. The posterior approach was done. A total laminectomy and removal of the lateral mass of the 5th cervical vertebrae were performed, and bone fragments and pellets were removed from the spinal canal, but an intradurally retained pellets were not totally removed. A dural laceration was noted intraoperatively, and CSF leakage was observed, so dura repair was done watertightly with prolene 6-0. The dura repair site was covered with fibrin glue and Tachocomb(R) Immediately, a lumbar drain was done. Radiographs included a postoperative CT scan and X-rays. The postoperative neurological status of the patient was improved compared with the preoperative neurological status. however, the patients developed symptoms of menigitis. He received lumbar drainage(200~250 cc/day) and ventilator care. After two weeks, panperitonitis due to duodenal ulcer perforation was identified. Finally, the patient died because of sepsis.
Summary
Original Article
Treatment of Combat-related Gunshot and Explosive Injuries to the Extremities
Jung Eun Lee, Young Ho Lee, Goo Hyun Baek, Kyung Hag Lee, Young Jae Cho, Yeong Cheol Kim, Gil Joon Suh
J Trauma Inj. 2013;26(3):111-124.
  • 1,219 View
  • 7 Download
AbstractAbstract PDF
PURPOSE
We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries.
METHODS
Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery.
RESULTS
All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases.
CONCLUSION
The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.
Summary

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