Öz
Yabancı maddelerin insan vücudu içinde yer değiştirmesi nadir görülen bir durum olup, göç mekanizması hiçbir zaman tam olarak açıklanamamıştır. Kalça bölgesinden av tüfeği ile yaralanan hastanın kalbinde dört adet saçma tanesine rastlanması nedeniyle bu olgu rapor edilmeye değer bulunmuştur. Av tüfeğiyle yaralanma tanısıyla acil servise getirilen hastanın muayenesinde; gluteal bölgede çok sayıda saçma giriş deliği olduğu, göğüs ve sırt bölgelerinde herhangi bir yaralanma izi olmadığı tespit edildi. Çekilen radyografilerde; kalça ve uyluk bölgelerinde çok sayıda saçma tanesi mevcuttu. Rutin olarak çekilen akciğer grafisinde mediastende kalbe uyan bölgede, dört adet saçma tanesi izlendi ve bu nedenle oluşabilecek komplikasyonlar açısından takip edildi. Özellikle saçma ile olan ateşli silah yaralanmalarında, yaralanma bölgesi fark etmeksizin saçma tanelerinin yer değiştirebileceği göz önüne alınarak beklenmedik komplikasyonlarla karşılaşılabileceği göz önüne alınmalıdır.
Anahtar Kelimeler
Av tüfeği yaralanması Saçma migrasyonu Yabancı cisim embolisi Akciğer filmi
Kaynakça
- 1. Aydın E, Dülgeroğlu TC, Metineren H. Migration of a Kirschner wire to the dorsolateral side of the foot following osteosynthesis of a patella fracture with tension band wiring- a case report. J Med Case Rep. 2016;10:41. Doi: 10.1186/s13256-016-0819-5.
- 2. Batın S, Ozan F, Gürbüz K, Uzun E, Kayalı C, Altay T. Migration of a Broken Kirschner Wire after Surgical Treatment of Acromioclavicular Joint Dislocation. Case Rep Surg. 2016;2016:6804670. Doi: 10.1155/2016/6804670.
- 3. Kalia A, Khatri K, Singh J, Bansal K, Sagy M. Broken Pieces of Cerclage Wire Lying in Soft Tissue Envelope Around Knee Joint- A Case Report and Review of Literature. J Orthop Case Rep. 2016;6(3):75-7. Doi: 10.13107/jocr.2250-0685.518.
- 4. Sharma SK, Sharma SK, Aslam M, Chadha GN. Intra-articular Migration of Broken Patellar Tension Band Wire- A Rare Case. J Orthop Case Rep. 2016;6(5):41-3. Doi: 10.13107/jocr.2250-0685.622.
- 5. Tan L, Sun DH, Yu T, Wang L, Zhu D, Li YH. Death Due to Intra-Aortic Migration of Kirschner Wire from the Clavicle- A Case Report and Review of the Literature. Medicine. 2016;95(21):e3741. Doi: 10.1097/MD.0000000000003741.
- 6. Leonardi F, Rivera F. Intravascular Migration of a Broken Cerclage Wire into the Left Heart. Orthopedics. 2014;37(10):e932-e935. Doi: 10.3928/01477447-20140924-90.
- 7. Karaman I, Kafadar IH, Oner M, Halici M. Intrapelvic pin migration after Salter innominate osteotomy and laparoscopic removal: a case report. J Pediatr Orthop B. 2013;22(6):533–5. Doi: 10.1097/BPB.0b013e32836422a0.
- 8. Chen Y, Sun C, Wang J, Li S, Zhao G, Lu Z. Migration of a Metallic Foreign Body into the Heart. J Card Surg. 2015;30(12):891-3. Doi: 10.1111/jocs.12648.
- 9. Hussein N, Rigby J, Abid Q. Bullet Embolus to the Right Ventricle Following Shotgun Wound to the Leg. BMJ Case Rep. 2012;14:2012. Doi: 10.1136/bcr-2012-007471.
- 10. Gutierrez V, Radice F. Late Bullet Migration into the Knee Joint. Arthroscopy. 2013;19(3):E15. Doi: 10.1053/jars.2003.50065.
- 11. Altınbaş Ö, Tanyeli Ö. Surgically managed gunshot injury of the heart; Bullet in the right coronary artery. J Surg Med. 2018;2(2):193-4. Doi: 10.28982/josam.407946.
- 12. Lyons FA, Rockwood CA. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am. 1990;72(8):1262–7.
- 13. Freund E, Nachman R, Gips H, Hiss J. Migration of a Kirschner wire used in the fixation of a subcapital humeral fracture, causing cardiac tamponade: case report and review of literature. Am J Forensic Med Pathol. 2007;28(2):155–6. Doi: 10.1097/PAF.0b013e31806195a1.
- 14. Rich NM, Collins GJ Jr, Andersen CA, McDonald PT, Kozloff L, Ricotta JJ. Missile emboli. J Trauma. 1978;18(4):236–9.
- 15. Gschwind CR. The intravenous foreign body: a report of 2 cases. J Hand Surg Am. 2002;27(2):350-4.
Öz
The replacement of foreign materials in the human body is rare and the exact mechanism of migration has never been entirely explained. This case was found worth reporting because of the pellets found in the heart of a patient injured by a shotgun through the hip region. The patient was brought to the emergency service because of a hunting rifle injury. Examination revealed numerous entry holes in the gluteal region but there was no sign of injury in the chest or back. On radiographs, there were numerous pellets in the hip and thigh regions. Routine chest X-ray showed four pellets within the mediastinum, probably within the heart, so patient was followed up to prevent probable complications. It should be considered that unexpected complications may be encountered in shotgun injuries due to migration of pellets regardless of the region of injury.
Anahtar Kelimeler
Shotgun wound Pellet migration Foreign body embolism Chest X-ray
Kaynakça
- 1. Aydın E, Dülgeroğlu TC, Metineren H. Migration of a Kirschner wire to the dorsolateral side of the foot following osteosynthesis of a patella fracture with tension band wiring- a case report. J Med Case Rep. 2016;10:41. Doi: 10.1186/s13256-016-0819-5.
- 2. Batın S, Ozan F, Gürbüz K, Uzun E, Kayalı C, Altay T. Migration of a Broken Kirschner Wire after Surgical Treatment of Acromioclavicular Joint Dislocation. Case Rep Surg. 2016;2016:6804670. Doi: 10.1155/2016/6804670.
- 3. Kalia A, Khatri K, Singh J, Bansal K, Sagy M. Broken Pieces of Cerclage Wire Lying in Soft Tissue Envelope Around Knee Joint- A Case Report and Review of Literature. J Orthop Case Rep. 2016;6(3):75-7. Doi: 10.13107/jocr.2250-0685.518.
- 4. Sharma SK, Sharma SK, Aslam M, Chadha GN. Intra-articular Migration of Broken Patellar Tension Band Wire- A Rare Case. J Orthop Case Rep. 2016;6(5):41-3. Doi: 10.13107/jocr.2250-0685.622.
- 5. Tan L, Sun DH, Yu T, Wang L, Zhu D, Li YH. Death Due to Intra-Aortic Migration of Kirschner Wire from the Clavicle- A Case Report and Review of the Literature. Medicine. 2016;95(21):e3741. Doi: 10.1097/MD.0000000000003741.
- 6. Leonardi F, Rivera F. Intravascular Migration of a Broken Cerclage Wire into the Left Heart. Orthopedics. 2014;37(10):e932-e935. Doi: 10.3928/01477447-20140924-90.
- 7. Karaman I, Kafadar IH, Oner M, Halici M. Intrapelvic pin migration after Salter innominate osteotomy and laparoscopic removal: a case report. J Pediatr Orthop B. 2013;22(6):533–5. Doi: 10.1097/BPB.0b013e32836422a0.
- 8. Chen Y, Sun C, Wang J, Li S, Zhao G, Lu Z. Migration of a Metallic Foreign Body into the Heart. J Card Surg. 2015;30(12):891-3. Doi: 10.1111/jocs.12648.
- 9. Hussein N, Rigby J, Abid Q. Bullet Embolus to the Right Ventricle Following Shotgun Wound to the Leg. BMJ Case Rep. 2012;14:2012. Doi: 10.1136/bcr-2012-007471.
- 10. Gutierrez V, Radice F. Late Bullet Migration into the Knee Joint. Arthroscopy. 2013;19(3):E15. Doi: 10.1053/jars.2003.50065.
- 11. Altınbaş Ö, Tanyeli Ö. Surgically managed gunshot injury of the heart; Bullet in the right coronary artery. J Surg Med. 2018;2(2):193-4. Doi: 10.28982/josam.407946.
- 12. Lyons FA, Rockwood CA. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am. 1990;72(8):1262–7.
- 13. Freund E, Nachman R, Gips H, Hiss J. Migration of a Kirschner wire used in the fixation of a subcapital humeral fracture, causing cardiac tamponade: case report and review of literature. Am J Forensic Med Pathol. 2007;28(2):155–6. Doi: 10.1097/PAF.0b013e31806195a1.
- 14. Rich NM, Collins GJ Jr, Andersen CA, McDonald PT, Kozloff L, Ricotta JJ. Missile emboli. J Trauma. 1978;18(4):236–9.
- 15. Gschwind CR. The intravenous foreign body: a report of 2 cases. J Hand Surg Am. 2002;27(2):350-4.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Ortopedi |
| Bölüm | Olgu sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 4 Sayı: 3 |
