Ulus Travma Acil Cerrahi Derg. 2022; 28(11): 1641-1644 | DOI: 10.14744/tjtes.2021.17260

Air gun injury to the pericardium in a 9-year-old boy

Robert Polak¹, Josef Vodicka¹, Vladislav Treska¹, Jiri Siroky², Jan Benes^3
1Department of Surgery, Charles University Faculty of Medicine in Pilsen, University Hospital Pilsen, Czech Republic
²Department of Cardiac Surgery, University Hospital Pilsen, Czech Republic
³Department of Anesthesiology and Intensive Care Medicine, Charles University Faculty of Medicine in Pilsen, University Hospital Pilsen, Czech Republic

The authors present the case of a 9-year-old boy who sustained a gunshot injury to the pericardium by an air gun. The penetrative wound to the pericardium was, according to the performed pre-operative diagnostic methods, initially believed to be a penetrative wound into the cardiophrenic angle of the left pleural cavity. The stabilized patient was indicated for an extraction of the projectile through a left anterior minithoracotomy, during which the projectile was found and successfully removed from the pericardium. The limits of pre-operative assessment, optimal treatment procedures, and surgical approaches in pediatric patients with gunshot injuries to the chest and heart are discussed.

Keywords: Air gun, computed tomography, echocardiography, penetrative injury; pericardiotomy.

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Dokuz yaþýndaki bir çocukta perikardda hava tabancasý yaralanmasý

Robert Polak¹, Josef Vodicka¹, Vladislav Treska¹, Jiri Siroky², Jan Benes^3
1Charles Üniversitesi Pilsen Týp Fakültesi, Pilsen Üniversite Hastanesi, Cerrahi Anabilim Dalý, Çek Cumhuriyeti
²Pilsen Üniversite Hastanesi, Kalp Cerrahisi Anabilim Dalý, Çek Cumhuriyeti
³Pilsen Charles Üniversitesi Týp Fakültesi, Pilsen Üniversite Hastanesi, Anesteziyoloji ve Týbbý Yoðun Bakým Bölümü, Çek Cumhuriyeti

Bu yazýda, hava tabancasý ile perikarda kurþun isabet eden dokuz yaþýndaki bir erkek çocuðu olgusu sunuldu. Perikarddaki penetran yaralanmanýn, ameliyat öncesi uygulanan taný yöntemlerine göre, baþlangýçta sol plevral boþluðun kardiyofrenik açýsýna nüfuz eden bir yaralanma olduðuna inanýlýyordu. Stabilize edilen hastada, sol anterior minitorakotomi yoluyla mermi bulunarak perikarddan baþarýyla çýkarýlmýþtýr. Burada, göðüs ve kalpte ateþli silah yaralanmasý olan pediatrik hastalarda ameliyat öncesi deðerlendirmenin sýnýrlarý, optimal tedavi prosedürleri ve cerrahi yaklaþýmlar tartýþýlmýþtýr.

Anahtar Kelimeler: Bilgisayarlý tomografi, ekokardiyografi, hava tabancasý, penetran yaralanma; perikardiyotomi.

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