Case Presentation: Conservative Management of Penetrating Torso Injury
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Transcript of Case Presentation: Conservative Management of Penetrating Torso Injury
Brief History & Physical Examination
An 18 year-old male presented with bullet injury from a hand gun to the chest & abdomen admitted on October, the 27th at 9:00 pm.
Inlet: the Rt. 6th intercostal space medial to the midclavicular line, impacted in subcutaneous tissue of the Rt. 11th intercostal space at posterior axillary line.
O/E: Conscious, in severe pain, PR=90, BP=110/80.Abdomen: Soft, tender Rt. Hypochondrium with
guarding.
U/SAn ill-defined hyperechoic area seen in anterior
segment of right lobe of the liver, 38*33 mm in diameter with an anterior anechoic tract seen inside the lesion. (liver contusion with haematoma).
Normal pericardium.Mild Rt side pleural effusion.
Management:Rehydration done, triple antibiotic & ATS given, with
good pain control.Close monitoring done with hourly vital signs
checking + measurement of in put & out put.The patients condition was stable & steady at
hospital.
CECT of AbdomenRt lobe, anterior inferior segment laceration along
bullet tract, with bullet arrest at Rt posterolateral abdominal wall, associated with mild Rt pleural effusion of mixed density (haemothorax), normal rest of liver paranchymal density.
Out come On 30th Oct afternoon the bullet extracted under local
anesthesia & wound debridement done for the inlet.On 31st Oct the patient discharged on oral antibiotics
& simple oral analgesics.