Journal of Trauma and Injury

Case Report

Damage control thoracotomy with chest packing for hemorrhage control in massive hemothorax and shock: a case report: Shivinder Singh, Jitendra Kumar Singh, Shalendra Singh, Aishwainee VG, Umesh Kumar, Venkat Narayanan; Received March 10, 2025 Accepted May 15, 2025 Published online September 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0066 [Epub ahead of print]

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Abstract PDF: Severe hemorrhagic shock is a leading cause of death among potentially salvageable casualties. We report the case of a 24-year-old man who sustained a gunshot wound to the right hemithorax and presented with class IV hemorrhagic shock. He underwent resuscitative damage control via a right posterolateral thoracotomy. Intraoperatively, the bleeding source was identified as a lacerated posterior intercostal artery at the level of the 11th dorsal vertebra. Because access to the bleeding site remained limited even after extending the incision, right thoracic packing was performed to control the hemorrhage. On reevaluation 48 hours later, no active bleeding was observed.; Summary

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

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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

Citations

Citations to this article as recorded by

Penetrating chest injury caused by a rubber bullet in a Republic of Korea Army soldier: a case report
Chansin Lee, Kyungwon Lee
Journal of Acute Care Surgery.2025; 15(3): 164. CrossRef

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

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Abstract 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

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Abstract 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

Citations

Citations to this article as recorded by

Features of Diagnosis and Surgical Treatment of Fragment Embolism of the Right Ventricle in Mine-Blast Injuries
Rostyslav M. Vitovskyi, Kostiantyn V. Gumeniuk, Volodymyr V. Isayenko, Andii R. Vitovskyi, Olga M. Unitska, Vasyl V. Lazoryshynets
Ukrainian Journal of Cardiovascular Surgery.2025; 33(3): 112. CrossRef
Diagnosis and surgical treatment of fragmented wounds of the heart and diaphragm with migration to the right ventricle in wartime conditions
V. V. Lazorishinets, R. M. Vitovskyi, O. M. Unitska, A. R. Vitovskyi, S. Sandu, V. V. Filipchuk
The Ukrainian Journal of Clinical Surgery.2025; 92(6): 105. CrossRef

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