Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review
Introduction. Surgery for cardiac trauma is considered fatal and for wounds of the colon by associated sepsis is normally considered; however, conservative management of many traumatic lesions of different injured organs has progressed over the years. Presentation of the Case. A 65-year-old male pat...
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| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2018/7839465 |
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| author | Paula M. Jaramillo Jaime A. Montoya David A. Mejia Salin Pereira Warr |
| author_facet | Paula M. Jaramillo Jaime A. Montoya David A. Mejia Salin Pereira Warr |
| author_sort | Paula M. Jaramillo |
| collection | DOAJ |
| description | Introduction. Surgery for cardiac trauma is considered fatal and for wounds of the colon by associated sepsis is normally considered; however, conservative management of many traumatic lesions of different injured organs has progressed over the years. Presentation of the Case. A 65-year-old male patient presented with multiple shotgun wounds on the left upper limb, thorax, and abdomen. On evaluation, he was hemodynamically stable with normal sinus rhythm and normal blood pressure, no dyspnea, or abdominal pain. Computed tomography (CT) scan of the chest shows hematoma around the aorta without injury to the blood vessel wall with an intramyocardial projectile without pericardial effusion. CT scan of the abdomen showed pellets in the transverse colon and descending colon endoluminal without extravasation of contrast medium or intra-abdominal fluid. The patient remains hemodynamically stable, and nonsurgical procedure was established. Discussion. Patients with asymptomatic intramyocardial projectiles can be safely managed without surgery. Nonsurgical management is only possible in asymptomatic patients with trauma of the colon through close surveillance and with very selective patients since standard management is surgery. Conclusion. Nonsurgical management of cardiac trauma, as well as colon penetrating trauma, can be performed in carefully selected patients with proper clinical follow-up, imaging, and laboratory studies. |
| format | Article |
| id | doaj-art-0ff661f13bb94acabeddbe827129a388 |
| institution | OA Journals |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Case Reports in Surgery |
| spelling | doaj-art-0ff661f13bb94acabeddbe827129a3882025-08-20T02:02:32ZengWileyCase Reports in Surgery2090-69002090-69192018-01-01201810.1155/2018/78394657839465Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature ReviewPaula M. Jaramillo0Jaime A. Montoya1David A. Mejia2Salin Pereira Warr3Pablo Tobón Uribe Hospital, Department of Surgery, University of Antioquia, Medellin, ColombiaGastrointestinal Surgery and Digestive Endoscopy, National Cancer Institute, Militar Nueva Granada University, Bogotá, ColombiaPablo Tobón Uribe Hospital, Department of Surgery, University of Antioquia, Medellin, ColombiaPablo Tobón Uribe Hospital, Medellin, ColombiaIntroduction. Surgery for cardiac trauma is considered fatal and for wounds of the colon by associated sepsis is normally considered; however, conservative management of many traumatic lesions of different injured organs has progressed over the years. Presentation of the Case. A 65-year-old male patient presented with multiple shotgun wounds on the left upper limb, thorax, and abdomen. On evaluation, he was hemodynamically stable with normal sinus rhythm and normal blood pressure, no dyspnea, or abdominal pain. Computed tomography (CT) scan of the chest shows hematoma around the aorta without injury to the blood vessel wall with an intramyocardial projectile without pericardial effusion. CT scan of the abdomen showed pellets in the transverse colon and descending colon endoluminal without extravasation of contrast medium or intra-abdominal fluid. The patient remains hemodynamically stable, and nonsurgical procedure was established. Discussion. Patients with asymptomatic intramyocardial projectiles can be safely managed without surgery. Nonsurgical management is only possible in asymptomatic patients with trauma of the colon through close surveillance and with very selective patients since standard management is surgery. Conclusion. Nonsurgical management of cardiac trauma, as well as colon penetrating trauma, can be performed in carefully selected patients with proper clinical follow-up, imaging, and laboratory studies.http://dx.doi.org/10.1155/2018/7839465 |
| spellingShingle | Paula M. Jaramillo Jaime A. Montoya David A. Mejia Salin Pereira Warr Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review Case Reports in Surgery |
| title | Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review |
| title_full | Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review |
| title_fullStr | Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review |
| title_full_unstemmed | Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review |
| title_short | Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review |
| title_sort | nonoperative management of multiple penetrating cardiac and colon wounds from a shotgun a case report and literature review |
| url | http://dx.doi.org/10.1155/2018/7839465 |
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