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

Setiawan, Eko and Shofwan, Said and Anwar, Sumadi Lukman and Ovaditya, Shafira Zahra and Rizaldy, Rheza and Janitra, Grady (2021) Ultrasound with needle guiding exploration as a real-time modality for exploration of air rifle bullet close to cervical spine: A case report. International Journal of Surgery Case Reports, 81. ISSN 22102612

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Abstract

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. © 2021 The Authors

Item Type: Article
Additional Information: Cited by: 2; All Open Access, Gold Open Access, Green Open Access
Uncontrolled Keywords: adult; air gun; Article; bullet; case report; cervical spine; cervical vertebra; clinical article; echography; emergency ward; female; gunshot injury; human; male; neck pain; priority journal; third cervical vertebra; transverse process; X ray analysis; x-ray computed tomography; young adult
Subjects: R Medicine > RB Biomedical Sciences
Divisions: Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition
Depositing User: Sri JUNANDI
Date Deposited: 24 Sep 2024 07:31
Last Modified: 24 Sep 2024 07:31
URI: https://ir.lib.ugm.ac.id/id/eprint/4711

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