A clinical case of gunshot shrapnel penetrating wound of the chest with injury to the inferior vena cava with migration of a foreign body along the blood stream

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.6.266619

Abstract

Damage to the major vessels in a retroperitoneal trauma belongs to the category of the most difficult, including damage to the inferior vena cava.

The aim of the work is to demonstrate the features of clinical manifestations and tactical solutions of a gunshot fragment blind wound of the inferior vena cava with the migration of a foreign body along the blood stream.

Materials and methods. A case of a gunshot fragment wound of the inferior vena cava with migration of the foreign body along the blood stream was studied. An injured person underwent sCT with and without contrast, FAST protocol, general blood test, biochemical blood test, CBV was determined using the formula of Moore, hourly diuresis was measured.

Results. The patient was operated on for vital signs, the condition of the injured person was stabilized. During the revision of the abdominal cavity and paranephric tissue, no foreign body was identified. In the immediate postoperative period, the injured person underwent chest and abdominal CT, according to the data of that, a metal fragment was identified, which migrated along the inferior vena cava to the point of connection with the right atrium.

The injured man was operated on at another specialized facility, where the foreign body was removed using a surgical magnetic tool.

Conclusions. Fire damage to the inferior vena cava is classically accompanied by a severe general condition, massive blood loss, which requires urgent surgical interventions. Multi-component preoperative preparation, a clearly established diagnostic plan, a multidisciplinary approach based on the example of our clinical case allow saving life even in the most complex cases.

Author Biographies

V. I. Tsumbaliuk, National Academy of Medical Sciences of Ukraine, Kyiv

MD, PhD, DSc, Academician of the National Academy of Medical Sciences of Ukraine, President of the National Academy of Medical Sciences of Ukraine

I. A. Lurin, State Scientific Institution “Scientific and Practical Center of Preventive and Clinical Medicine” of the State Administration of Affairs, Kyiv

MD, PhD, DSc, Professor, National Academy of Medical Sciences of Ukraine, Vice President of the National Academy of Medical Sciences of Ukraine, Major General of the Medical Service

V. V. Makarov, Kharkiv National Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Surgery 4

V. V. Nehoduiko, Kharkiv Military Medical Clinical Center of the Northern Region, Ministry of Defense, Ukraine

MD, PhD, DSc, Associate Professor of the Department of Surgery, Kharkiv National Medical University

O. V. Buchnieva, SI “V. T. Zaitsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv

MD, PhD 

S. V. Tertyshnyi, Military Medical Clinical Center of the Southern Region, Odesa, Ukraine

MD, PhD, Lieutenant Colonel of the Medical Service, Head of the Surgical Infection Department

Y. V. Bunin, Kharkov Military Medical Clinical Center of thе of the Northern Region, Ministry of Defense, Ukraine

MD, Head of the Thoracoabdominal Surgery Clinic

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Published

2022-12-20

How to Cite

1.
Tsumbaliuk VI, Lurin IA, Makarov VV, Nehoduiko VV, Buchnieva OV, Tertyshnyi SV, Bunin YV. A clinical case of gunshot shrapnel penetrating wound of the chest with injury to the inferior vena cava with migration of a foreign body along the blood stream. Zaporozhye medical journal [Internet]. 2022Dec.20 [cited 2024Feb.24];24(6):760-4. Available from: http://zmj.zsmu.edu.ua/article/view/266619

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Section

Case Reports