Fotios Kyramargios (Pireus / GR), Stefanos Tsatsos (Pireus / GR), Nikolaos Giannakopoulos (Pireus / GR), Ioannis Papazacharias (Pireus / GR), Marios Merrakos (Pireus / GR), Nikolaos Melachroinopoulos (Pireus / GR), Nikolaos Vlachakos (Pireus / GR)
Abstract text (incl. references and figure legends)
CASE STORY
A 17 year old male patient was shot twice from a long distance with hand gun.
CLINICAL FINDINGS
The patient arrived in A&E ,from inspection the patient had three wounds which had relevant diameter to the bullet's caliper. . The patients was hemodynamically unstable with his blood pressure around 85/60 he was tachycardic and tachypnoic.
INVESTIGASTION/RESULTS
Immediately complete blood count was ordered and the results came back normal. A thoracoabdominal CT with intravenous infusion was done to inspect the bullets track. The CT revealed the bullet's site of entrance on the left lower hemithorax ,penetration of the spleen's parenchyma, posterior and anterior wall of the stomach and left lobe of liver. Finally the bullet found on the left anterior abdominal wall(fig1,2).
DIAGNOSIS
The diagnosis was penetrating abdominal gunshot wound
THERAPY AND PROGRESSIONS
Immediately exploratory laparotomy was done under midline incision ,big amount blood collection was found on left paracolic gutter ,the spleen was not viable so splenectomy was indicated ,the stomach"s anterior and posterior wall wounds were primarily sutured. The liver wound was packed with hemostatic gauze .Finally two penrose drainages were put in the left paracolic gutter and in Morrison"s space. The patient's postoperative period was uncomplicated and discharged on the 10th postoperative day.
COMMENTS
The penetrating abdominal gunshot wound is an exceptional category of open abdominal trauma because the abdominal region has vital parechymal and hollow organ in which the impact could threaten the patient's life.The inspection of site of entry and exit is of paramaount importance,moreover sometimes the patient directed to OR even without imaging studies.
REFERENCES
1)Zeineddin A, Williams M, Nonez H, Nizam W, Olufajo OA, Ortega G, Haider A, Cornwell EE.Gunshot Injuries in American Trauma Centers:Analysis of the Lethality of Multiple Gunshot Wounds. Am Surg. 2021 Jan;87(1):39-44.
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