scholarly journals Survival abdominal gunshot injury: a rare case

2018 ◽  
Vol 5 (5) ◽  
pp. 1935
Author(s):  
Ashok S. Gajbhiye ◽  
M. N. Deshmukh ◽  
Parag Jaipuriya ◽  
Parag Jaipuriya ◽  
P. Mehata ◽  
...  
Keyword(s):  
Foreign Body ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Exploratory Laparotomy ◽  
Abdominal Radiograph ◽  
Jejunal Segment ◽  
Firearm Injury ◽  
Single Entry ◽  
Restricted Use ◽  
Operative Recovery

A 55 years old male patient came to the casualty of a medical college and hospital with alleged history of assault with firearm injury on his back. Patient was conscious with GCS 15/15, his pulse rate was 133 beats per min, blood pressure was 100/60 mmHg, SpO2 was 95% and pallor was present. On local examination there was single entry wound at lower back on left side of size 1 cm X 1 cm with no exit wound. Generalized abdominal tenderness and guarding was present. Patient was immediately resuscitated. Blood grouping, cross match were sent immediately. Abdominal radiograph did not show any gas under the diaphragm but a foreign body (a bullet) was seen. Ultrasonography and computerized tomography scan of the abdomen was suggestive of hemoperitonium and a foreign body bullet in abdomen. Exploratory laparotomy showed moderate hemoperitonium of about 1000 ml which was sucked out completely. Evidence of retroperitoneal rent of size approximately 1 cm X 1 cm seen with oozing through it which was closed in layers. A bullet was seen in the anterior abdominal wall but skin was intact. Five jejunal perforations distal to 20 cm from the duodenojejunal flexure were seen and the bullet was removed from the anterior abdominal wall.  Resection of the jejunal segment with jejuno-jejunal anastomosis was done. Jejunal mesenteric rents were closed. Abdominal wall closed in layers. Post-operative recovery was uneventful. Patient was discharged on the 10th post-operative day. Early diagnosis and treatment in the golden hours can save the life of the patients. A mass education on the dangers of these guns and the harm they can cause as well as legal regulations for their restricted use seem to be necessary.

The reaction of the soft tissues of the anterior abdominal wall to various suture material

1982 ◽  
Vol 63 (4) ◽  
pp. 72-74
Author(s):  
V. P. Nefedov ◽  
R. M. Ramazanov
Keyword(s):  
Foreign Body ◽  
Abdominal Wall ◽  
Soft Tissues ◽  
Suture Material ◽  
Anterior Abdominal Wall ◽  
The Body ◽  
Reactive Changes ◽  
Healing Processes

The healing processes of sutured wounds of soft tissues in most cases depend on the type and quality of the suture material. Any kind of suture material in the tissues of the body is a foreign body that causes various reactive changes from the tissues. The nature of these changes, all other things being equal, is mainly determined by the type of suture material, its thickness and the method of sterilization of the tissues on which the sutures are applied, the trauma of surgery, the infection of the wound and the irritating effect of the threads on the tissues.

scholarly journals Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Christos Stefanou ◽  
Nicolaos Zikos ◽  
George Pappas-Gogos ◽  
Spyridon Koulas ◽  
Ioannis Tsimoyiannis
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Exploratory Laparotomy ◽  
Stable Patient ◽  
Imaging Studies ◽  
Abdominal Injuries ◽  
Penetrating Abdominal Trauma ◽  
Entry Wound ◽  
Accepted Practice ◽  
Lower Abdominal Wall

Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically.

scholarly journals Morphological Features of Foreign Body Giant Cells in Experimental Conditions

2021 ◽  
Vol 11 (2) ◽  
pp. 212-215
Author(s):  
Mariya Zatolokina ◽  
Ekaterina Mishina ◽  
Alexander Sozykin ◽  
Marina Gorbunova ◽  
Alexander Alekseev
Keyword(s):  
Foreign Body ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Morphological Changes ◽  
Giant Cells ◽  
The Body ◽  
Experimental Conditions ◽  
Multinucleated Cells ◽  
Foreign Body Giant Cells ◽  
Mesh Implant

Background: The purpose of our work was determined by the accumulation of a significant amount of experimental material under the conditions of implantation of a foreign body, a mesh implant, into the region of the anterior abdominal wall in order to obtain experimental inflammation, in which foreign body giant cells (FBGCs) were constantly visualized as reactive formations. This research aimed to study the dynamics of morphological changes in FBGCs under conditions of experimental implantation of a foreign body, a mesh implant, and the possible mechanism of their formation Methods and Results: This study was carried out on male Wistar rats, in which a foreign body was implanted—a mesh endoprosthesis made of polypropylene—in the region of the anterior abdominal wall under the aponeurosis of the rectus abdominis muscles. A section of the anterior abdominal wall with the implanted endoprosthesis was excised on Days 10, 21, 30, and 60 after surgery, fixed in 10% buffered formalin solution. The obtained samples were embedded in paraffin according to standard prescriptions; histological sections with a thickness of 5-7µm were made and stained with H&E, according to the methods of Van Gieson and Mallory, and an immunohistochemical study was performed using the marker of cell proliferation (Ki-67). The revealed structural features of multinucleated cells were recorded by microphotography using a photo attachment and a Levenhuk video camera (USA). During the study, it was revealed that the amount, functional activity and morphological diversity of FBGCs gradually increased, reaching a maximum by Day 30 of the experiment. At a later date, some of them died, while the remaining part was differentiated, splitting into small multinucleated cells and mononuclear elements, morphologically identical to macrophages and fibroblasts. The formation of FBGCs continued as long as the mesh implant was in the body. Conclusion: FBGCs are reactive formations that arise in response to various endo- and exogenous irritation.

Determination of clinical efficiency of deproteinized dialysate from blood of milk-fed calves after endoprosthetics in patients with ventral hernias

2020 ◽  
Vol 28 (3) ◽  
pp. 323-333
Author(s):  
Sergej V. Ivanov ◽  
Ilya S. Ivanov ◽  
Evgenij G. Obyedkov ◽  
Liliya P. Popova
Keyword(s):  
Abdominal Wall ◽  
Inflammatory Reaction ◽  
Inflammatory Process ◽  
Anterior Abdominal Wall ◽  
Dynamic Change ◽  
Main Group ◽  
Control Group ◽  
Surgical Department ◽  
Regeneration Stage

Aim. To study the influence of deproteinized dialysate from blood of milk-fed calves on the type of exudative discharge and dynamics of inflammatory reaction after hernia repair with plastics of the anterior abdominal wall with hernioendoprosthesis of polypropylene. Materials and Methods. The study involved 59 patients being on stationary treatment in the surgical department of Kursk Regional Clinical Hospital. Patients were hospitalized for the herniation of small or medium dimension. The patients were divided to two groups: the main (n=30) and control (n=29) groups. After endoprosthetics, the patients of the control group were given complex conservative treatment. The patients of the main group, besides standard treatment, were administered deproteinized dialysate from blood of milk-fed calves intravenously in drips 10 ml + 200 ml of 0.9% sodium chloride solution within 7 days. For cytological examination and determination of the type of cytograms, the traumatic discharge was collected and analyzed using the method of M.F. Kamaev and M.A. Palthsev. Results. Cytomorphometric examination was conducted on the third, fifth and seventh day after endoprosthetics with the aim of studying dynamic changes. Determination of cell composition and also of its changes characteristic of each studied period, was necessary for obtaining further information characterizing inflammatory process in the region of placement of the endoprosthesis. After endoprosthetics in patients who were administered hemodialysate, the inflammatory reaction was less pronounced than in patients who did not receive the preparation. This was associated with a more dynamic change of stages of the inflammatory process. In patients of the main group who received deproteinized dialysate, regenerative type of inflammation first appeared on the fifth day and made 6.9%; by the seventh day the share of patients with the regenerative type rose to 17.5%, while in the patients of the control group no regeneration stage was observed in both periods. Conclusion. Analysis of the efficiency of influence of hemodialysate on the inflammatory reaction in plastics of the anterior abdominal wall with polypropylene endoprosthesis evidences faster course of all stages of inflammation and reduction of its intensity by 10%.

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