Long-term Fistula Formation Due to Retained Bullet in Lumbar Spine after Gunshot Injury

Jeon,  Se Il; Im,  Soo Bin; Jeong,  Je Hoon; Cha,  Jang Gyu

doi:2017.30.2.51

J Trauma Inj > Volume 30(2); 2017 > Article

Case Report

Journal of Trauma and Injury 2017;30(2):51-54.
DOI: https://doi.org/10.20408/jti.2017.30.2.51 Published online June 30, 2017.

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

¹Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Gyeonggi-do, Korea. isbrzw@gmail.com
²Department of Radiology, Soonchunhyang University Bucheon Hospital, Gyeonggi-do, Korea.

Received: 23 December 2016 • Revised: 10 February 2017 • Accepted: 10 February 2017

Abstract

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.

Key Words: Gunshot; Spine; Bullet injury; Metal toxicity