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Gunshot wound causing complete spinal cord injury without mechanical violation of spinal axis: Case report with review of literature.

Patil R, Jaiswal G, Gupta TK - J Craniovertebr Junction Spine (2015 Oct-Dec)

Bottom Line: Gunshot wound (GSW) forms the major bulk of PSI.Due to easy availability of firearms and antisocial behavior, GSW which were predominant in military population is now increasingly seen in civilized society.Here, we present a detail case review of unique case of civilian GSW indirectly causing complete spinal cord injury due to shock wave generated by the bullet, along with its systematic management.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, R.N.T. Medical College, Udaipur, Rajasthan, India.

ABSTRACT
Penetrating spine injury (PSI) forms the third most common cause of spine injury, only next to road traffic accidents and fall. Gunshot wound (GSW) forms the major bulk of PSI. Due to easy availability of firearms and antisocial behavior, GSW which were predominant in military population is now increasingly seen in civilized society. Here, we present a detail case review of unique case of civilian GSW indirectly causing complete spinal cord injury due to shock wave generated by the bullet, along with its systematic management.

No MeSH data available.


Related in: MedlinePlus

X-ray chest lateral view showing the bullet with no bony injuries
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Figure 1: X-ray chest lateral view showing the bullet with no bony injuries

Mentions: A 38-year-old male farmer was accidentally shot by riffle pistol firearm weapon in the dorsal region of back with no exit wound. Bullet was fire from close range (distance of 6-8 meters). Patient was vitally stable on admission with. Glasgow coma scale score of 15/15, paraplegia (power in both L.L Grade = 0) with complete loss of all type of sensation below D10 level. There was an entry wound in left posterior axillary line at the level of 10th rib. Patient underwent immediate contrast-enhanced computed tomography (CT) thorax and abdomen, which showed Grade III spleen laceration with left and right lung contusion and foreign bodies in lateral wall of right chest in intramuscular compartment at the level of 8th rib with right sided hemopneumothorax and hemoperitonium with no obvious bony injury [Figures 1, 2 and 5]. Patient underwent immediate exploration of thorax and abdomen with spleenectomy with repair of gastric perforation with jejunostomy with right sided implantable cardioverter-defibrillators placed with removal of bullet from chest. After stabilization of general condition magnetic resonance imaging (MRI) spine was done, which showed abnormal signal in the intra-medullary compartment of the cord at D11-L1 level s/o cord contusion/cord edema [Figures 3 and 4]. Patient was manage conservatively for cord contusion and was then discharge. On follow-up after 12 months patients power in both Lower limb is Grade 0.


Gunshot wound causing complete spinal cord injury without mechanical violation of spinal axis: Case report with review of literature.

Patil R, Jaiswal G, Gupta TK - J Craniovertebr Junction Spine (2015 Oct-Dec)

X-ray chest lateral view showing the bullet with no bony injuries
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660489&req=5

Figure 1: X-ray chest lateral view showing the bullet with no bony injuries
Mentions: A 38-year-old male farmer was accidentally shot by riffle pistol firearm weapon in the dorsal region of back with no exit wound. Bullet was fire from close range (distance of 6-8 meters). Patient was vitally stable on admission with. Glasgow coma scale score of 15/15, paraplegia (power in both L.L Grade = 0) with complete loss of all type of sensation below D10 level. There was an entry wound in left posterior axillary line at the level of 10th rib. Patient underwent immediate contrast-enhanced computed tomography (CT) thorax and abdomen, which showed Grade III spleen laceration with left and right lung contusion and foreign bodies in lateral wall of right chest in intramuscular compartment at the level of 8th rib with right sided hemopneumothorax and hemoperitonium with no obvious bony injury [Figures 1, 2 and 5]. Patient underwent immediate exploration of thorax and abdomen with spleenectomy with repair of gastric perforation with jejunostomy with right sided implantable cardioverter-defibrillators placed with removal of bullet from chest. After stabilization of general condition magnetic resonance imaging (MRI) spine was done, which showed abnormal signal in the intra-medullary compartment of the cord at D11-L1 level s/o cord contusion/cord edema [Figures 3 and 4]. Patient was manage conservatively for cord contusion and was then discharge. On follow-up after 12 months patients power in both Lower limb is Grade 0.

Bottom Line: Gunshot wound (GSW) forms the major bulk of PSI.Due to easy availability of firearms and antisocial behavior, GSW which were predominant in military population is now increasingly seen in civilized society.Here, we present a detail case review of unique case of civilian GSW indirectly causing complete spinal cord injury due to shock wave generated by the bullet, along with its systematic management.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, R.N.T. Medical College, Udaipur, Rajasthan, India.

ABSTRACT
Penetrating spine injury (PSI) forms the third most common cause of spine injury, only next to road traffic accidents and fall. Gunshot wound (GSW) forms the major bulk of PSI. Due to easy availability of firearms and antisocial behavior, GSW which were predominant in military population is now increasingly seen in civilized society. Here, we present a detail case review of unique case of civilian GSW indirectly causing complete spinal cord injury due to shock wave generated by the bullet, along with its systematic management.

No MeSH data available.


Related in: MedlinePlus