Presentation
A small metallic fragment has been shot with pressure against the abdomen while working air compression tools.
Patient Data
Small metallic foreign body project over the level of L4 vertebral body, slightly to the left of the midline. Although no convincing signs of pneumoperitoneum are seen, CT is recommended to better assess the injured viscera.
Metallic foreign body in the mesentery at the level of the L3/L4 intervertebral disc. Small volume free intraperitoneal air is in keeping with perforation of a hollow viscus. There is thickening of a mid-small bowel loop anterior to the foreign body, highly suspicious for the point of penetration. There is also thickening of the inferior anterior wall of the superior adjacent mid transverse colon, that may also be affected. No other evidence of acute traumatic injury is identified in the abdomen or pelvis.
Hepatic steatosis and left lobe hepatic cyst.
Image intensifier in ...
Image intensifier in theater resected mesentery
Resected specimen confirming the presence of the foreign body in it.
A dashed circle showing the foreign body.
Case Discussion
An uncommon type of traumatic abdominal injury presenting similarly to a gunshot injury.