Ultrasound with needle guiding exploration as a real-time modality for exploration of air rifle bullet close to cervical spine: A case report

Autor: Said Shofwan, Grady Janitra, Eko Setiawan, Sumadi Lukman Anwar, Shafira Zahra Ovaditya, Rheza Rizaldy
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: International Journal of Surgery Case Reports
ISSN: 2210-2612
Popis: Highlights • Real-time imaging modalities are needed while performing surgical exploration of retained foreign body. • Ultrasonography offered an ability to visualize retained foreign body in a real-time. • Needle guiding ultrasonography is a technique that allows surgeon to extracts the retained foreign body precisely. • The combination of a needle guided ultrasonography, and other imaging studies may increase the accuracy of exploration.
Introduction and importance Surgical exploration of retained air rifle bullet at the neck region is challenging because it is difficult to find bullets during exploration and prevent damage to vital structures. A bedside real-time imaging technique is needed to determine the retained bullet's location to the surrounding structures and guiding exploration. Case presentation A 19-year-old male patient was admitted to the emergency department with neck pain after being shot by an air rifle. The patient's vital signs were stable. A small entry wound to the right lateral side of the neck without exit wound was found without neurological symptoms. The cervical X-ray showed the bullet at the third cervical vertebrae level. Surgical exploration was performed with needle-guiding ultrasonography. The bullet is a one-centimeter anterior transverse process of the third cervical vertebra marked by a hyperechoic object. Exploration was done by tracing the needle. Postoperative neurological evaluation was conducted, and no abnormalities were found. Clinical discussion Preoperative imaging modalities are crucial before the surgical exploration of a retained air rifle bullet. X-ray and CT-scan are imaging modalities that are often used as an initial assessment of retained foreign bodies. However, ultrasonography provides advantages over X-ray and CT scan to provide real-time imaging that supports the surgeon while performing surgical exploration. Ultrasonography with needle guiding exploration increases the precise location of a retained air rifle bullet. Conclusion Ultrasonography was a simple and precise real-time imaging modality for identifying and guiding the exploration of a retained air rifle bullet in the neck area.
Databáze: OpenAIRE