1/20. eye injuries associated with paintball guns.AIMS: This study identifies the various types of ocular injuries sustained after blunt trauma with a paintball fired from a paintball gun. methods: We report two patients who sustained injury to an eye after being shot with a paintball and review similar cases presented in the world literature. The type of injury sustained and the final visual acuity obtained after a paintball hit to the eye are examined. RESULTS: The two boys presented were hit in the eye with a paintball resulting in lens subluxation, hyphema formation, and angle recession. cataract extraction was required in both cases. One boy also had an optic neuropathy and a choroidal rupture. A review of the literature reveals a variety of injuries occur after a paintball hit to the eye. In some of the cases, the damage to the eye has led to loss of vision and at times loss of the eye. CONCLUSIONS: Paintball guns can cause devastating ocular injuries. Wearing protective eye and face gear during this game is essential. We recommend that an anti-fog face mask with a one-piece polycarbonate eye shield be worn by those participating in paintball games.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/20. Transfemoral extraction of an intracardiac bullet embolus.Missiles may reach the heart via direct penetration of the thoracic cavity or indirectly by means of the venous circulation. Often the hemodynamic stability of the patient dictates the approach that is used not only to retrieve the projectile but also to repair associated life-threatening injuries. The case of a 40-year-old man with an intracardiac missile after a gunshot wound to the right gluteal area is presented along with the transfemoral technique used to recover an intracardiac projectile. This approach may be used instead of thoracotomy for missile extraction in stable patients.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
3/20. Conservative management of a pulmonary artery bullet embolism: case report and review of the literature.A case of pulmonary artery bullet embolism managed by observation with no complications at 9-month follow-up prompted a review of the literature. We found a total of 32 cases reported since 1966, with no deaths. Fourteen of the patients were managed by observation and five patients were followed with no resulting complications noted. Conservative management of selected cases of pulmonary artery bullet emboli may be warranted in light of the risks of extraction. These cases should continue to be reported with follow-up.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/20. Plastic bullet arterial embolization following gunshot injury to the heart. Case report and review of the literature.A plastic bullet penetrating the heart through the right ventricle embolized to the right profunda. Suture of the heart and extraction of the bullet resulted in uneventful recovery. The literature revealed 21 instances of embolization following proven heart penetration, in two cases through the right ventricle.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/20. Split 24-F Amplatz dilator for percutaneous extraction of an intravascular bullet: case report and technical note.An intravascular bullet was retrieved percutaneously in a 17-year-old boy with the use of a modified 24-F Amplatz dilator. The dilator was modified by means of a longitudinal incision with removal of a wedge at the distal tip of the tapered portion of the dilator. The bullet, which was located in the left pulmonary artery, was removed via the right femoral vein. No complications occurred.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |
6/20. Venous bullet embolism: rationale for mandatory extraction.Venous missile embolism is a rare complication of penetrating trauma which poses controversial management options. We report a case of hepatic vein bullet embolism treated by percutaneous transvenous basket relocation and extraction via femoral vein cutdown. A review of 102 reported bullet emboli since 1930 indicates that the morbidity of a retained projectile is substantial (25%), while removal using modern techniques has few complications. Salient features of early extraction include: 1) prevention of proximal migration, 2) transvenous relocation of the missile to an accessible vein, and 3) peripheral surgical removal. Delayed recognition of an asymptomatic bullet embolus demands further judgment in guiding selective operative removal. A management scheme based on time of recognition, patient status, and embolus characteristics is presented for this unusual problem.- - - - - - - - - - ranking = 6keywords = extraction (Clic here for more details about this article) |
7/20. A posterior arthroscopic approach to bullet extraction from the hip.A 22-year-old male sustained a gunshot injury to the left hip region. The bullet lodged in the articular surface of the femoral head posterosuperomedially. The location of the bullet within the hip joint stimulated the performance of an arthroscopy of the hip through a posterior approach. The authors are unaware of any other report in the literature describing such an approach. To minimize the dangers, a limited posterior incision was made and deepened through the short rotators. The arthroscope was introduced through the incision to perforate the posteroinferior portion of the hip joint capsule. The bullet was easily visualized with a 70 degree arthroscope. Positioning at the joint and traction are vital components to visualization. The use of three-dimensional CT scanning is an aid to the graphic understanding of the bullet's pathway and relations to the surfaces of the hip joint.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |
8/20. Hepatic vein bullet embolus as a complication of left thoracic gunshot injury.The case of a patient with a hepatic vein bullet embolus complicating a left ventricular gunshot injury is described. The patient presented hypotensive with a left midaxillary entrance wound. Initial radiographs showed a bullet fragment below the right hemidiaphragm. Emergency open thoracotomy was performed with release of a tense pericardial effusion and repair of a left ventricular penetrating wound. Surgical exploration failed to reveal direct penetrating injury to the diaphragm or abdominal viscera. After a hepatic venogram localized the bullet fragment in a branch of the right lobe hepatic vein, a periscopically directed catheter extraction of the fragment was successfully performed. A discussion of missile embolization, its pathology, clinical presentation, diagnosis, and management is presented.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/20. thrombophlebitis following a bullet embolus to the popliteal vein.A patient who had a bullet embolus to the right popliteal vein developed an extensive thrombophlebitis from the popliteal to the common iliac vein. We suggest that following extraction of a bullet that has embolized to a major extremity vein, it may be necessary to anticoagulate the patient.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
10/20. In-utero gunshot wound to the head. Use of intraoperative ultrasonography for localization of an intracerebral projectile.Approaching full gestational age, a 1700-g male fetus sustained a penetrating gunshot wound to the left parietal region of the head while in utero. The child was delivered by emergency caesarean section. Initially in profound fetal shock and with almost no neurological function, the child was eventually stabilized. A posttraumatic intracerebral porencephalic cyst developed, with the projectile moving freely within the confines of the cyst cavity. Six weeks after the initial injury, the patient underwent an operation for extraction of the projectile. The Neuro SectOR ATL ultrasound probe was used intraoperatively and was instrumental in determining the exact position of the intracerebral projectile.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
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