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Penetrating right ventricular injury following a single gunshot to the left flank in Iraq: a case report

  • Zryan Salar Majeed (Department of Thoracic and Cardiovascular Surgery, Shar Teaching Hospital) ;
  • Yad N. Othman (Department of Thoracic and Cardiovascular Surgery, Shar Teaching Hospital) ;
  • Razhan K. Ali (Department of Thoracic and Cardiovascular Surgery, Shar Teaching Hospital)
  • Received : 2022.11.16
  • Accepted : 2022.12.26
  • Published : 2023.09.30

Abstract

A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.

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References

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