title: Penetrated sigmoid colon by air gun pellet could be life threatening: A case report.
abstract: BACKGROUND
  Air and paintball guns have been in existence for over 400 year. Although serious injury or death can result from the use of such guns, previous literature has not mentioned the issue of the penetration of the sigmoid colon by an air gun pellet.
  
  
  METHODS
  We report a rare case of a 44-year-old Caucasian woman referred to abdominal surgery after an accidental small wound had occurred in the lower left abdominal quadrant that was caused by an air gun pellet. The blood and biochemical analyses were normal but the CT scan revealed the presence of a foreign body - an air gun pellet in the left iliac region of the abdomen. Clinically, during the initial 24h significant changes were not noticed. After 42h, however, pain and local tenderness in the lower left abdominal quadrant was expressed. A laparotomy revealed a retained pellet in the wall of the sigmoid colon and a small leak with colonic content with consecutive local peritonitis also occurred. The foreign body was removed and the opening edges in the colon were excised and closed with the primary suture.
  
  
  CONCLUSIONS
  The hollow organs of the digestive tract, albeit very rarely penetrated by an air gun pellet, do not typically show all signs of an acute abdomen in the early posttraumatic phase. Such injuries can lead to a pronounced infection, which may cause septic shock if not appropriately treated.
  
  
  CONCLUSIONS
  For correct diagnosis, a careful approach and several daily clinical observations are required.
authors.affiliation: Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo; Department of Abdominal Surgery, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo. Electronic address: avdyl.krasniqi@yahoo.com.
authors.forename: Avdyl S
authors.initials: AS
authors.lastname: Krasniqi
authors.affiliation: Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo; Department of Abdominal Surgery, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo.
authors.forename: Astrit R
authors.initials: AR
authors.lastname: Hamza
authors.affiliation: Department of Abdominal Surgery, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo.
authors.forename: Valon A
authors.initials: VA
authors.lastname: Zejnullahu
authors.affiliation: Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo; Department of Anesthesiology and Reanimation, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo.
authors.forename: Fatos E
authors.initials: FE
authors.lastname: Sada
authors.affiliation: Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo; Department of Abdominal Surgery, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo.
authors.forename: Besnik X
authors.initials: BX
authors.lastname: Bicaj
keywords: Air gun pellet; Peritonitis; Sigmoid colon perforation