Migration of foreign bodies of firearms origin

Abstract

Objective. To analyse the results of diagnosis and treatment of wounded with gunshot combat trauma, in which foreign body migration was recorded, and to determine their optimal algorithm.
 Materials and methods. The data of anamnesis, objective clinical and general clinical and laboratory studies, as well as the results of instrumental diagnostics (radiological, endoscopic, ultrasound examinations) of 67 wounded with blind gunshot wounds of various localisations were analysed. Thoracic, laparoscopic and arthroscopic surgical interventions were performed on a video endoscopic stand, and surgical magnetic instruments were used to diagnose and remove ferromagnetic foreign bodies.
 Results. The main directions of foreign body migration are the respiratory tract, gastrointestinal tract, vascular bed, cavities (pleural, abdominal, joints) and soft tissues in case of suppuration. Foreign body fixation occurs in the place of narrowing of an artery or vein, distal parts of the respiratory tract, gentle parts of the pleural or abdominal cavity, in organs with structural features (heart, intestine, joint).
 Conclusions. Although the migration of foreign bodies of gunshot origin is rare, it requires appropriate attention and response.
 In case of gunshot penetrating wounds of cavities (thoracic, abdominal, large joints), to which foreign bodies may migrate, preference should be given to minimally invasive endoscopic methods of their removal using modern magnetic instruments.