Abstract
To study the incidence, pattern of injuries, presentation and management of stray bullet injuries. All patients presented and admitted with stray bullet injuries during a period of 4 years from January 2006 to December 2010 were included in this prospective study which was conducted at Liaquat University of Medical and Health Sciences Hospital Hyderabad/Jamshoro. All of the study subjects were admitted through casualty and were initially thoroughly examined and resuscitated. The pattern of injuries was noted and requisite investigations performed. Patients who sustained injuries demanding surgery were prepared accordingly and were submitted for laparotomy or other procedures depending upon the severity of injuries. The data collected on individual basis and variables studied including demographics, pattern of injuries, time since injury occurred and management. A total number of 165 patients with a mean age of 17.1 years, SD 13.807 and range of 74(2-76) presented with stray bullet injuries during study period. The study population comprised 117(70.90%) males and 48(29.09%) females. Majority of the patients were brought late because of delay in diagnosis or delay in transportation. The commonest victims were young children in their teens and comprised 78% of the study population. Haemothorax/ pneumothorax or peritonitis was the common presentations occurring in 11% and 61.81% of the study population respectively. Of the total number, 92 (55.75%) patients underwent laparotomy while remaining patients either had chest intubation or some other procedures done accordingly. Nine (5.45%) patients developed permanent disabilities while 13(7.87%) patients died either immediately after arrival or later on in the hospital during or after the operative treatment. Mortality was related to the time of arrival in hospital since the injury and thus was highest among those brought 4 or more hours after the shot (P<0.001). Patients who did not sustain major injuries were kept under observation and were subsequently discharged. Stray bullet injuries are an ever increasing challenge in our society. Unlawful and jubilant use of weapons in celebrations, weddings and similar occasions are causing a lot of morbidity and mortality in the society.
Highlights
Protests and aggressive mobs are commonly controlled by using force, and aerial firing is a well known tool used by administrative bodies to disperse the unlawful destructive and aggressive mobs
Stray gun fire celebrations of festivals like kite festival is claiming many lives every year in Pakistan. This trend had raised the incidence of stray bullet injuries to a substantially high level which has become an open threat to the civil society
A total of 165 patients regardless of age and gender were admitted in our ward with a history of some sudden unknown injury and were diagnosed to have sustained a stray bullet injury in a number of different circumstances such as to rejoice victories, aerial firing to disperse the mobs, celebrating firings, injury by a returning bullet while sleeping etc
Summary
There is a global increase in unintended fire arm injuries from Europe, to America, UK and Asia. Public uprisings, protests and aggressive mobs are commonly controlled by using force, and aerial firing is a well known tool used by administrative bodies to disperse the unlawful destructive and aggressive mobs. Stray gun fire celebrations of festivals like kite festival is claiming many lives every year in Pakistan. This trend had raised the incidence of stray bullet injuries to a substantially high level which has become an open threat to the civil society. A number of such stray bullet casualties are being reported by youngsters allegedly involved in alcohol abuse. We are facing this problem of stray bullet injuries ever since there is a surge of illegal weapons in the market especially with those who have gangs behind them or some political support. This study was performed to study the incidence, pattern and management of these stray bullet injuries in a major city of Sind province of Pakistan
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