1887
  1. الرئيسية
  2. A-Z Publications
  3. Journal of Emergency Medicine, Trauma and Acute Care
  4. المجلد 2024, العدد 7
  5. المقالة
Volume 2024, Issue 7
  • ISSN: 1999-7086
  • E-ISSN: 1999-7094

ملخص

There is a scarcity in the literature on the management of retained bullet injuries (RBIs), and there are no comprehensive treatment guidelines. This study reports a single-center experience in the management of thoracoabdominal RBIs in resource-limited settings.

A retrospective study of 103 patients diagnosed with RBIs was conducted between January 2004 and December 2020 at Al-Nasar Hospital in Ibb, Yemen. Clinical demographic data, RBI occurrence and settings, injury characteristics, management, and outcomes were collected and analyzed.

The mean age was 36.0 ± 16.2 years, and most cases (75.7%) were men. Most RBIs occurred during wedding ceremonies (52.4%), while 37 (35.9%) occurred during war and political rallies, and 12 (11.7%) occurred during usual times. RBIs during wedding ceremonies were statistically significant compared with other injury times ( < 0.001). Among the victims, 42.7% were unaware of the injury. The chest wall was the most common site of RBIs ( = 42, 40.8%), followed by the thoracoabdominal area in 28 (27.2%) cases and the back in 15 (14.6%) cases. All patients underwent surgical exploration except for four (3.9%) cases, and chest tube insertion was the most common procedure ( = 42, 40.8%). Four patients (3.9%) were permanently disabled, while nine (8.7%) died in the hospital during or after surgery. Mortality rates were significantly associated with time to hospital arrival, with longer delays resulting in death ( < 0.001).

In this study, RBIs primarily affected adult men during wedding ceremonies, with chest wall injuries being the most common and chest tube insertion being the most common procedure. Mortality rates were higher with delayed hospital admissions. Strategies of prevention initiatives should focus on raising awareness, vigilant law enforcement, and improving prehospital care.

© 2024 Ghabisha, Al-wageeh, Ahmed, Badheeb, Almirah, licensee HBKU Press.
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References

  1. Al-Tarshihi MI, Al-Basheer M. The falling bullets: Post-Libyan revolution celebratory stray bullet injuries. Eur J Trauma Emerg Surg. 2014 Feb; 40(1):83–5. doi: 10.1007/s00068-013-0323-1.
     [Google الباحث العلمي]
  2. Dees J. The Gun Without the Silver Bullet: Violence, Masculinity and Individuality in America's Gun Culture 2.0 [Internet]; 2020. Available from https://theses.ubn.ru.nl/server/api/core/bitstreams/63c38989-9a9e-4332-8c85-0893759a99b7/content .
     [Google الباحث العلمي]
  3. Malik AM, Alkadi A, Talpur KAH, Naeem Quresh J. The incidence, pattern and outcome of stray bullet injuries. A growing challenge for surgeons. Pak J Med Sci. 2013 Sep–Oct; 29(5):1178-81. doi: 10.12669/pjms.295.3794.
     [Google الباحث العلمي]
  4. Andrade EG, Uberoi M, Hayes JM, Thornton M, Kramer J, Punch LJ. The impact of retained bullet fragments on outcomes in patients with gunshot wounds. Am J Surg. 2022Apr; 223(4):787–91. doi: 10.1016/j.amjsurg.2021.05.022.
     [Google الباحث العلمي]
  5. Batley N, Bakhti R, Bachir R, Mufarrij AF. Stray bullet injuries in a tertiary care center. Signa Vitae. 2016Oct; 12(1):106-110. doi: 10.22514/SV121.102016.18.
     [Google الباحث العلمي]
  6. Gani F, Sakran JV, Canner JK. Emergency Department visits for firearm-related injuries in the United States, 2006-14. Health Aff (Millwood). 2017 Oct 1; 36(10):1729–38. doi: 10.1377/hlthaff.2017.0625.
     [Google الباحث العلمي]
  7. Ordog GJ, Wasserberger J, Balasubramanium S. Wound ballistics: Theory and practice. Ann Emerg Med. 1984Dec; 13(12):1113–22. doi: 10.1016/s0196-0644(84)80336-4.
     [Google الباحث العلمي]
  8. Stefanopoulos PK, Filippakis K, Soupiou OT, Pazarakiotis VC. Wound ballistics of firearm-related injuries–part 1: Missile characteristics and mechanisms of soft tissue wounding. Int J Oral Maxillofac Surg. 2014Dec; 43(12):1445–58. doi: 10.1016/j.ijom.2014.07.013.
     [Google الباحث العلمي]
  9. Stefanopoulos PK, Mikros G, Pinialidis DE, Oikonomakis IN, Tsiatis NE, Janzon B. Wound ballistics of military rifle bullets: An update on controversial issues and associated misconceptions. J Trauma Acute Care Surg. 2019Sep; 87(3):690–8. doi: 10.1097/TA.0000000000002290.
     [Google الباحث العلمي]
  10. Abdali HA, Hoz SS, Moscote-Salazar LR. Cranial gravitational (falling) bullet injuries: Point of view. J Neurosci Rural Pract. 2018 Apr-Jun; 9(2):278–80. doi: 10.4103/jnrp.jnrp_498_17.
     [Google الباحث العلمي]
  11. Zgheib H, Shayya S, Wakil C, Bachir R, El Saye. MJ. Gunshot injuries in Lebanon: Does intent affect characteristics, injury patterns, and outcomes in victims? J Emerg Trauma Shock. 2019 Apr-Jun; 12(2):117–22. doi: 10.4103/JETS.JETS_135_18.
     [Google الباحث العلمي]
  12. Incorvaia AN, Poulos DM, Jones RN, Tschirhart JM. Can a falling bullet be lethal at terminal velocity? Cardiac injury caused by a celebratory bullet. Ann Thorac Surg. 2007;83:283–4. doi: 10.1016/j.athoracsur.2006.04.046.
     [Google الباحث العلمي]
  13. Baum GR, Baum JT, Hayward D, MacKay BJ. Gunshot wounds: Ballistics, pathology, and treatment recommendations, with a focus on retained bullets. Orthop Res Rev. 2022;14:293–317. doi: 10.2147/ORR.S378278.
     [Google الباحث العلمي]
  14. Yong YE. A systematic review on ricochet gunshot injuries. Leg Med (Tokyo). 2017 May;26:45–51. doi: 10.1016/j.legalmed.2017.03.003.
     [Google الباحث العلمي]
  15. Grosse Perdekamp M, Kneubuehl BP, Serr A, Vennemann B, Pollak S. Gunshot-related transport of micro-organisms from the skin of the entrance region into the bullet path. Int J Legal Med. 2006Sep; 120(5):257–64. doi: 10.1007/s00414-005-0073-7.
     [Google الباحث العلمي]
  16. Rivara FP, Hink AB, Kuhls D, Banks S, Agoubi LL, Kirkendoll S, et al.. Firearm injuries in Missouri. PLoS One. 2023Nov; 18(11):e0294737. doi: 10.1371/journal.pone.0294737.
     [Google الباحث العلمي]
  17. Wigton A. Firearm-related injuries and deaths among children and adolescents in Cape Town–1992–1996. S Afr Med J. 1999Apr; 89(4):407–10.
     [Google الباحث العلمي]
  18. Wani AA, Ramzan AU, Shoib Y, Malik NK, Nizami FA, Dhar A, et al.. Stray bullet: An accidental killer during riot control. Surg Neurol Int. 2011;2:122. doi: 10.4103/2152-7806.84769.
     [Google الباحث العلمي]
  19. Ayub S, Amir S, Mushtaq, Khan I, Nasir M. Incidence, pattern, and outcome of stray bullet injuries: Three years’ experience in a teaching institute. Pak J Neurol Surg. 2022;26(3):521–8. doi: 10.36552/pjns.v26i3.788.
     [Google الباحث العلمي]
  20. Gybalo RV, Lurin IA, Safonov V, Dudla DI, Oklei DV, Dinets A. Retained bullet in the neck after gunshot wounds to the chest and arm in combat patient injured in the war in Ukraine: A case report. Int J Surg Case Rep. 2022 Oct;99:107658. doi: 10.1016/j.ijscr.2022.107658.
     [Google الباحث العلمي]
  21. Ali SA, Tahir SM, Makhdoom A, Shaikh AR, Siddique AJ. Aerial firing and stray bullet injuries: A rising tide. Iran Red Crescent Med J. 2015Apr; 17(4):e26179. doi: 10.5812/ircmj.17(4)2015.26179.
     [Google الباحث العلمي]
  22. Lichte P, Oberbeck R, Binnebosel M, Wildenauer R, Pape HC, Kobbe P. A civilian perspective on ballistic trauma and gunshot injuries. Scand J Trauma Resusc Emerg Med. 2010;18:35. doi: 10.1186/1757-7241-18-35.
     [Google الباحث العلمي]
  23. Nagpal BM, Menon A. Clinical features and management of blast injuries. Med J Armed Forces India. 2002Oct; 58(4):335–7. doi: 10.1016/S0377-1237(02)80091-0.
     [Google الباحث العلمي]
  24. Stawicki SPA. Trends in nonoperative management of traumatic injuries – A synopsis. Int J Crit Illn Inj Sci. 2017 Jan–Mar; 7(1):38–57. doi: 10.4103/IJCIIS.IJCIIS_7_17.
     [Google الباحث العلمي]
  25. Horowitz K, McKay M, Marshall R. Community violence and urban families: Experiences, effects, and directions for intervention. Am J Orthopsychiatry. 2005Jul; 75(3):356–68. doi: 10.1037/0002-9432.75.3.356.
     [Google الباحث العلمي]
  26. Dubrow NF, Garbarino J. Living in the war zone: Mothers and young children in a public housing development. Child Welfare. 1989 Jan-Feb; 68(1):3–20.
     [Google الباحث العلمي]
  27. Kalesan B, French C, Fagan JA, Fowler DL, Galea S. Firearm-related hospitalizations and in-hospital mortality in the United States, 2000–2010. Am J Epidemiol. 2014 Feb 1; 179(3):303–12. doi: 10.1093/aje/kwt255.
     [Google الباحث العلمي]
  28. Wintemute GJ, Wright MA, Drake CM, Beaumont JJ. Subsequent criminal activity among violent misdemeanants who seek to purchase handguns: risk factors and effectiveness of denying handgun purchase. JAMA. 2001 Feb 28; 285(8):1019–26. doi: 10.1001/jama.285.8.1019.
     [Google الباحث العلمي]
  29. Newgard CD, Kuppermann N, Holmes JF, Haukoos JS, Wetzel B, Hsia RY, et al.. Gunshot injuries in children served by emergency services. Pediatrics. 2013Nov; 132(5):862–70. doi: 10.1542/peds.2013-1350.
     [Google الباحث العلمي]
/content/journals/10.5339/jemtac.2024.36
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Treatment outcomes of retained bullet injuries to thoracoabdominal area: Insights from a single-center experience from Yemen
Journal of Emergency Medicine, Trauma and Acute Care 2024, 36 (٢٠٢٤); https://doi.org/10.5339/jemtac.2024.36
/content/journals/10.5339/jemtac.2024.36
/content/journals/10.5339/jemtac.2024.36
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  • نوع المستند: Research Article
الموضوعات الرئيسية bullet removal, complications, gunshots, outcomes and retained bullets

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