title: Case Report on the Demonstration of Minute Colonic Perforations Caused by Birdshot Injury.
abstract: Penetrating trauma of the colon is usually diagnosed intraoperatively and missed injuries cause considerable morbidity and mortality. Herein, we described an intraoperative diagnostic method for invisible openings on the colon due to a birdshot injury. A 30-yearold man was admitted to the hospital after sustaining gunshot pellet injuries to his abdomen, back, and extremities. Emergency laparotomy relieved splenic injury and free pellet fragments in the abdomen. A pellet fragment was also palpated in the descending colon. Despite meticulous inspection of the colon, it failed to show the entrance of the pellet. An 18F catheter was passed through the anus and was connected to a CO2 insufflator of the laparoscopy unit. The abdominal cavity was filled with normal saline and 1.5 l of CO2 was inflated into the rectum. Five tiny (2-mm) openings on the retroperitoneal part of the descending colon were demonstrated with the help of the air bubbles. All of the openings were sutureligated and his postoperative course was uneventful. We believe that inflating the colon in cases of abdominal birdshot injuries may allow the demonstration of tiny perforations and provide immediate repairs of missed injuries.
authors.affiliation: Department of General Surgery, Odemis State Hospital, Odemis, Turkey.
authors.forename: Ismet
authors.initials: I
authors.lastname: Emeklioglu
authors.affiliation: Department of General Surgery, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey. cuneytkayaalp@hotmail.com.|Department of General Surgery, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey. cuneytkayaalp@hotmail.com.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kayaalp
authors.affiliation: Department of General Surgery, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey.
authors.forename: Cemalettin
authors.initials: C
authors.lastname: Aydin
keywords: Abdominal trauma; Colon; Diagnosis; Gunshot
references.citation: Injury. 1987 Jan;18(1):15-7
references.pmid: 3440608
references.citation: Surg Clin North Am. 1997 Dec;77(6):1291-304
references.pmid: 9431340
references.citation: Br J Surg. 1990 Oct;77(10):1095-7
references.pmid: 2136198
references.citation: Am J Forensic Med Pathol. 1996 Jun;17(2):151-4
references.pmid: 8727292
references.citation: J Trauma. 1996 Aug;41(2):276-82
references.pmid: 8760536
references.citation: Surg Clin North Am. 1991 Apr;71(2):399-418
references.pmid: 2003258
references.citation: Eur J Surg. 1993 Jan;159(1):49-51
references.pmid: 8095807
references.citation: Surg Clin North Am. 1997 Dec;77(6):1321-32
references.pmid: 9431342
references.citation: Circ J. 2002 Jul;66(7):707-8
references.pmid: 12135144
references.citation: Injury. 2005 Sep;36(9):1011-5
references.pmid: 16098326
references.citation: Eur J Surg Oncol. 2003 Apr;29(3):239-43
references.pmid: 12657233
references.citation: J Trauma. 1988 Jul;28(7):962-7
references.pmid: 3398094
references.citation: Clin Orthop Relat Res. 2003 Mar;(408):28-57
references.pmid: 12616039
references.citation: Ann Emerg Med. 2004 Mar;43(3):344-53
references.pmid: 14985662