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  4. Successful Removal of a Bullet from the Spinal Canal of a GSW Victim in the Level of L5: Case Report

Successful Removal of a Bullet from the Spinal Canal of a GSW Victim in the Level of L5: Case Report

International Journal of Surgery Case Reports, 2022 · DOI: https://doi.org/10.1016/j.ijscr.2022.107779 · Published: November 11, 2022

SurgeryResearch Methodology & Design

Simple Explanation

Gunshot wounds are becoming more common and are a significant cause of injury and death, especially among young people. This is often due to increasing violence in cities. When someone is shot, the main goal is to save their life and reduce any lasting nerve damage. This report describes the case of a 25-year-old man who was shot and had the bullet lodged in his spine. Doctors performed multiple surgeries, including removing the bullet. After the operation, the patient's walking ability improved. Treating gunshot wounds to the spine is complex. The focus is on providing immediate trauma care, maintaining spinal stability, and minimizing nerve damage. This case shows that surgery to remove a bullet can help improve a patient's ability to walk if they have nerve deficits.

Study Duration
4-month follow-up
Participants
One 25-year-old male gunshot wound victim
Evidence Level
Level 4, Case Report

Key Findings

  • 1
    The patient, a 25-year-old male, presented with a gunshot wound to the left flank, resulting in hemodynamic shock and lethargy.
  • 2
    Damage control surgery was performed to address intra-abdominal bleeding and injuries to the intestines, mesentery, and ureter.
  • 3
    Surgical removal of the bullet from the spinal canal at the L5 level, along with L2-S1 laminectomy, led to improved left foot drop and walking ability.

Research Summary

This case report details the successful surgical removal of a bullet from the spinal canal of a 25-year-old gunshot wound victim, leading to improved neurological function. The patient underwent damage control surgery to address abdominal injuries before the bullet was removed from the L5 level of the spine. The outcome highlights the potential benefits of surgical intervention in select cases of spinal gunshot wounds, particularly when neurological deficits are present.

Practical Implications

Surgical Intervention

Surgical removal of bullets from the spinal canal may be considered in young patients with incomplete or progressive neurological deficits, unstable spines, or persistent neural compression.

Damage Control

Prioritize hemodynamic resuscitation and damage control surgery in cases of spinal cord gunshots before addressing spinal injuries.

Neurological Assessment

Careful neurological assessment is critical to determine the need for surgical intervention.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of comparative data on surgical versus non-surgical management.
  • 3
    Short follow-up period of 4 months.

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