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Case Reports
. 2021 Apr:81:105700.
doi: 10.1016/j.ijscr.2021.105700. Epub 2021 Feb 24.

A retained intrahepatic bullet in the Bermuda triangle: A case report of surgical extraction

Mohamed Abdel Wahab  1 , Hosam Hamed Hamed Asar  2 , Rihame M Abdel Wahab  3 , Khalid Marzouk  4 , Amr Kassem  5
Affiliations
Case Reports

A retained intrahepatic bullet in the Bermuda triangle: A case report of surgical extraction

Mohamed Abdel Wahab et al. Int J Surg Case Rep. 2021 Apr.

Abstract

Introduction and importance: The management of retained gunshot injury in the liver is not properly discussed in the literature.

Case presentation: We describe a rare case of intrahepatic retained foreign body (bullet). Our patient is a 39-year old Yemeni soldier, who was exposed to firearm injury 10 months previously. The patient sought medical advice to extract the foreign body, and it was successfully extracted through abdominal exploration, with no intraoperative or postoperative complications.

Discussion: Retained liver foreign bodies have three types, penetrating, medical, and migrating. Before the removal of the foreign body, good patient evaluation along with good surgical expertise should be present.

Conclusion: There is a need for general guidelines to manage such patients who should be assessed by high volume surgeons.

Keywords: Abdominal trauma; Firearm injury; Liver trauma; Retained foreign body.

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Figures

Fig. 1
Fig. 1
(A) Sagittal view of an abdominal CT with contrast (venous phase) showing the bullet in front of the IVC, and adjacent to the right hepatic vein. (B) CT hepatic venography showing the relation between the bullet (Blue arrow) and the three hepatic veins. (C) 3-d reconstruction of the previous image.
Fig. 2
Fig. 2
(A) The fibrous tissue surrounding the bullet tract as seen from the anterior surface of the liver. (B) Intraoperative fluoroscopy showing the bullet location (Blue arrow). (C) Bullet after extraction.
See this image and copyright information in PMC

References

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