Perforation of the Colon from the Primary Blast Effect of an Extraperitoneal Shotgun Injury - Case Report
Authors: Polychronidis, Alexandros; Bounovas, Anastasios; Perente, Sebachedin; Laftsidis, Prodromos; Polychronidis, Alexandros; Simopoulos, Constantinos
Source: Military Medicine, Volume 172, Number 3, March 2007 , pp. 327-328(2)
Abstract:Blast trauma can result in injuries to peritoneal organs. Penetrating extraperitoneal shotgun wounds and even tangential gunshot or shotgun injuries of the abdominal or chest wall can result in damage to abdominal organs despite an intact peritoneum and diaphragm. Delays in diagnosis and operative repair of such bowel injuries are frequently associated with high morbidity and mortality rates. We present a case of a 47-year-old man with a history of depression and a self-inflicted shotgun wound to the chest wall, which was tangential and never entered the chest cavity. Computed tomography of the chest revealed free subdiaphragmatic air. Exploratory laparotomy revealed a 4-cm perforation of the wall of the splenic flexure of the large bowel. There was no injury to the peritoneum, diaphragm, or other abdominal viscera. The colonic perforation was repaired by suturing with a stapling instrument. The operation was completed with an appendectomy and cecostomy.
Document Type: Research Article
Publication date: March 2007
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Military Medicine is the Association's official monthly journal. The objective of the Journal is to promote awareness of Federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to Federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members' writings.
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