Firearm injury to the left buttock with uterus penetrating trauma

Filomena Pezzullo, MD; Valeria Marrone, MD; Rosita Comune, MD; Carlo Liguori, MD; Alessandro Borrelli, MD; Roberta Abete, MD; Stefano Giusto Picchi, MD; Nicola Rosano, MD; Raffaele D'avino, MD; Francesca Iacobellis, MD; Riccardo Ferrari, MD; Michele Tonerini, MD; Stefania Tamburrini, MD

Radiology Case Reports (Dec 2024)

Firearm injury to the left buttock with uterus penetrating trauma

Filomena Pezzullo, MD,
Valeria Marrone, MD,
Rosita Comune, MD,
Carlo Liguori, MD,
Alessandro Borrelli, MD,
Roberta Abete, MD,
Stefano Giusto Picchi, MD,
Nicola Rosano, MD,
Raffaele D'avino, MD,
Francesca Iacobellis, MD,
Riccardo Ferrari, MD,
Michele Tonerini, MD,
Stefania Tamburrini, MD

Affiliations

Filomena Pezzullo, MD: Department of Radiology, Ospedale del Mare, Naples, Italy
Valeria Marrone, MD: Department of Radiology, Ospedale del Mare, Naples, Italy
Rosita Comune, MD: Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy; Corresponding author.
Carlo Liguori, MD: Department of Radiology, Ospedale del Mare, Naples, Italy
Alessandro Borrelli, MD: Department of General and Emergency Surgery, Ospedale del Mare, Naples, Italy
Roberta Abete, MD: Department of General and Emergency Surgery, Ospedale del Mare, Naples, Italy
Stefano Giusto Picchi, MD: Department of Radiology, Ospedale del Mare, Naples, Italy
Nicola Rosano, MD: Department of Radiology, Ospedale del Mare, Naples, Italy
Raffaele D'avino, MD: Department of General and Emergency Surgery, Ospedale del Mare, Naples, Italy
Francesca Iacobellis, MD: Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, Napoli, Italy
Riccardo Ferrari, MD: Department of Emergency Radiology, San Camillo Forlanini Hospital, Rome, Italy
Michele Tonerini, MD: Department of Emergency Radiology, Cisanello Hospital, Pisa, Italy
Stefania Tamburrini, MD: Department of Radiology, Ospedale del Mare, Naples, Italy

Journal volume & issue: Vol. 19, no. 12
pp. 5639 – 5647

Abstract

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A multispecialty trauma team must provide care for pelvic gunshot wounds (PGW) due to the high risk of associated morbidity and mortality, the high density of organs that might be wounded within the pelvis, and the potential consequences of these complicated injuries. We present a case of a 59-year-old woman hemodynamically stable with firearm injury to the left buttock. CT examination showed free air in the peritoneal cavity and in the retroperitoneum and a focal contrast extravasation within the uterine fundus. The patient underwent urgent laparotomy that revealed triple bowel perforation (sigmoid colon, medium rectum, ileum) and a laceration of the posterior and anterior uterine wall at level of the cervix with no signs of active bleeding. The bullet was lodged above the peritoneal reflection, in the right pelvis, and it was removed, and handed over to the judicial authority. The perforated bowel segments were resected with Hartmann's procedure and ileal anastomosis. The uterine laceration was repaired. Although all the viscera and the structures along the trajectory can be harmed, pelvic gunshot wounds have the potential to inflict serious injury. Nongravid uterine traumas are a unique occurrence, and proper care requires an understanding of lesion grading. Finding the gynecological lesion in female patients is essential to receiving the best care and protecting the reproductive system.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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