Air Gun Injuries Research Articles

Pneumocephalus and Pneumomediastinum from Compressed Air Injury to Conjunctiva

A 30-year-old healthy man presented with bilateral eye swelling and chest and neck pain after compressed air gun injury to the right eye. He had normal ocular vitals with best-corrected visual acuity (BCVA) 20/30 and intraocular pressure of 17 mmHg by tonometry. Anterior segment examination showed multiple conjunctival lacerations as the only point of entry and loculated subconjunctival emphysema (A). Fundus examination was unremarkable. Air presumably tracked through multiple structures leading to orbital emphysema, pneumocephalus (B), and subcutaneous emphysema causing pneumomediastinum extending to the diaphragm (C-D). He was given erythromycin ointment, ocular lubrication, and systemic antibiotics. At follow-up, BCVA was 20/20 with healed conjunctival abrasions and resolution of systemic sequela (Magnified version of Figure A-D is available online at www.aaojournal.org).

FULL ENDOSCOPIC SURGERY OF BULLET REMOVAL OF THE SPINE: A CASE REPORT

Background: In the past decade, the endoscopic technique has been applied as a feasible and less invasive approach to orthopedic surgeries. Minimally invasive, full-endoscopic surgery has gained considerable attention in managing air gun injuries to the spine. Sacrum injuries among air gun wounds are rare and few have been published in case reports. Here, we present the management of air gun-bullet injury to the pediatric spinal spine in a 5-year-old child using endoscopic surgical intervention.Case Report: A 5-year-old girl was accidentally shot in the lower back with an air gun. The CT scan imaging shown a retained projectile in the pedicle of S1 vertebrae without vascular injury or unstable vertebral fracture. A minimally invasive, full-endoscopic surgical technique was applied to remove the bullet in this patient. On post-surgical follow-up, the patient was in a good recovery state.Discussion: Surgical intervention is needed for decompression, stabilization, and diminished risks of lead toxicity. The percutaneous endoscopic approach is the least invasive intervention performed to ensure a targeted approach through the anatomical openings of the spine and through intervertebral discs and bone structures, thereby further reducing spinal instability, blood loss, and infection risk.Conclusion: The endoscopic operation of minimally invasive surgical techniques is an effective operative approach not only limited in spinal stenosis cases, but also in air gun injuries.

CHARACTERISTICS OF CTEV PATIENTS AT ORTHOPEDIC AND TRAUMATOLOGY OUTPATIENT CLINIC IN DATU BERU GENERAL HOSPITAL TAKENGON CENTRAL ACEH PERIOD AUGUST 2018-JULY 2022

Background: In the past decade, the endoscopic technique has been applied as a feasible and less invasive approach to orthopedic surgeries. Minimally invasive, full-endoscopic surgery has gained considerable attention in managing air gun injuries to the spine. Sacrum injuries among air gun wounds are rare and few have been published in case reports. Here, we present the management of air gun-bullet injury to the pediatric spinal spine in a 5-year-old child using endoscopic surgical intervention.Case Report: A 5-year-old girl was accidentally shot in the lower back with an air gun. The CT scan imaging shown a retained projectile in the pedicle of S1 vertebrae without vascular injury or unstable vertebral fracture. A minimally invasive, full-endoscopic surgical technique was applied to remove the bullet in this patient. On post-surgical follow-up, the patient was in a good recovery state.Discussion: Surgical intervention is needed for decompression, stabilization, and diminished risks of lead toxicity. The percutaneous endoscopic approach is the least invasive intervention performed to ensure a targeted approach through the anatomical openings of the spine and through intervertebral discs and bone structures, thereby further reducing spinal instability, blood loss, and infection risk.Conclusion: The endoscopic operation of minimally invasive surgical techniques is an effective operative approach not only limited in spinal stenosis cases, but also in air gun injuries.

Near-Fatal Air Gun Injury in a Child – Case Report

Sri Lanka Journal of Medicine is the official journal of the Kandy Society of Medicine. It is a peer-reviewed journal currently published biannually. Original articles, reviews, brief reports, case reports, points of view, and letters to the editor, in all fields of medical science and practice are accepted for publication.The Sri Lanka Journal of Medicine is now indexed in DOAJ

Air gun injury

Air gun injury

Air guns and their wider relevance to the dental profession.

Crimes involving air guns have declined over the last 16 years in England and Wales; however, still represent a significant occurrence, with 3,028 crimes involving air guns reported in 2019 (just under one-third of all firearm crime). We aim to present points regarding air gun injuries and their wider relevance to the dental profession which have not been covered in previous publications.This article covers air gun licensing in the UK and the relevant safeguarding issues, as well as optimal imaging of suspected retained pellets in the head and neck.Whilst there are numerous case reports of retained air gun pellets found in various regions of the head and neck, only a handful of papers discuss the issues in leaving retained pellets or a surgical approach to removal of these pellets. This article summarises the current approaches and provides a suggested protocol for the management of pellets in the head and neck, as well as highlighting the need for further development in this field.Air gun pellets as retained foreign bodies may be identified on routine examination of the head and neck, both in general dental practice and in oral and maxillofacial surgery departments. This article acts as an overview and guide for dental professionals to gain a wider understanding of these injuries and their management.

Subcutaneous and visceral emphysema due to industrial air gun injury

A 21-year-old man presented to our emergency department suffering for right arm tightness and stiffness with mild pain following a high-pressure air working injury. On examination, the right hand palm showed a small gunshot wound (Figure 1), a swelling and crepitus was palpable from the tips of the fingers through to the whole upper limb extending up to the lateral right cervical region. No neurological impairments or fever were recorded. His vital signs were stable and laboratory tests were within a normal range (WBC 8.39 109/L mmc, CRP 0.10 mg/dL, fibrinogen 245 mg/dL). The wound was irrigated, cleaned and sterile dressing was applied. The right hand x-ray resulted negative for acute fracture.

Scare air gun-induced ocular trauma in an agriculture farm in India

Purpose: The purpose was to highlight the potential dangers of the air gun loaded with carbide commonly used by the farmers, causing injury to the eye. Scare airguns are used to prevent the birds from destroying the crops in their fields. Method: This was an observational study. Results: A 44-year-old Indian male presented to us with redness, diminution of vision, and mucopurulent discharge in his right eye (RE). On evaluation, it showed lid edema, excoriations, conjunctival congestion, corneal epithelial defect, anterior chamber inflammation, and hyphema in his RE. On his last follow-up a month later, hyphema and anterior chamber inflammation had resolved in his RE with an improved visual acuity. He was also educated about the dangers of using illegal air guns. Conclusion: Eye protection should be used when using devices that are inflammable. Ocular air gun injuries can range from some causing minor corneal abrasions to potentially serious ones. Due to the timely evaluation and treatment of our patient, the patient did not suffer significant visual morbidity.

Air Guns: A Contemporary Review of Injuries at Six Pediatric Level I Trauma Centers

BackgroundStudies spanning the last three decades demonstrated the injury causing capability of air gun (AG) projectiles. Recent studies have suggested the impact and incidence of these injuries may be declining because of edcational efforts. We hypothesize that injuries in the pediatric population resulting from AGs remain a significant health concern. MethodsA retrospective review (1/1/2007 to 12/31/2016), of AG-injured children < 19 years old, was performed across six level I Pediatric Trauma Centers, part of the ATOMAC research consortium. AG injuries were defined as injuries sustained by ball-bearing or pellet air-powered guns. Paint ball and soft foam AGs were excluded. Following institutional review board approval, patients were identified by ICD code from the trauma registry. Included were demographic data, injury severity scores, length of stay (LOS), outcome at discharge, and overall cost of admission. Descriptive statistics and parametric tests were employed. ResultsA total of 499 patients sustained injuries. Mean age 9.5 (±4.0) y; 81% of victims were male; all survived to hospital discharge. 30% (n = 151) required operative intervention. Hospital LOS was 2.3 (±2.2) d; with mean cost of $23,756 (±$34,441). Injury severity score mean of 3.7 (±4.6) on admission. Over 40% of the injuries to the head/thorax that were severe (AIS ≥ 3) required operative intervention (P < 0.001). ConclusionsAG injuries to the head or thorax seen at trauma centers were likely to require operative management. While no fatalities occurred, the cost was substantial. This study demonstrates pediatric injuries resulting from AG projectiles remain a significant health concern.

Toy Guns, Real Danger: An Update on Pediatric Injury Patterns Related to Nonpowder Weapons

BackgroundDesign changes of nonpowder guns, including BB and air guns, have significantly increased their potential to injure. We sought to characterize the demographics of children injured with nonpowder weapons and the specific injuries suffered. MethodsA cross-sectional analysis of the study years 2006, 2009, and 2012 was performed by combining the Kids' Inpatient Database into a single dataset. We identified cases (age < 21 years) of air gun injuries using external cause of injury codes. Patient characteristics and injuries were analyzed using ICD-9 codes, and national estimates were obtained using case weighting. ResultsThere were 1028 pediatric admissions for nonpowder weapon related injuries. The victims were predominately male (87.0%), non-Hispanic white (52.3%), resided in the South (47.3%), and in the lowest income quartile (39.2%). Half required a major surgical procedure. The predominant injuries were open wounds to the head, neck, or trunk (40.3%), and contusion (22.5%). Notable other injuries were intracranial injury (9.1%) and blindness or vision defects (3.3%). ConclusionsThe nonpowder weapons available to this generation can paralyze, blind, and cause lasting injury to children. Injuries frequently require surgical intervention, and these weapons should no longer be considered toys. Further research and legislation should be aimed at limiting children's access to these weapons. Level of evidenceIII.

Firearm injuries in rural Saudi Arabia: incidence, patterns, management, and cost

BackgroundA retrospective study from 2013 to 2017 was conducted to evaluate the incidence of small firearms and air gun injuries, social demographics of victims, severity of injuries, patterns, length of stay, and cost of hospitalization in highly populated central rural Al Kharj region of Saudi Arabia.ResultsIn total, the study included 102 cases. The incidence of firearms and air gun injuries in Al Kharj region was 3.13/100,000. Most of the victims were young-aged males (98 cases; 96.1%). The males were absolute majority with the rate of males to females 23.5:1. There were no fatal injuries in this study and no suicides. Majority of the cases were accidents or usage of firearms as toys. The most common site of entry was the lower limb (44 cases; 43.1%), the abdomen (20 cases; 19.6%), and the upper limbs (16 cases, 15.7%). Handguns were the cause of injuries in 66 cases (64.7%) and air guns in 36 cases (35.3%) respectively. The median Injury Severity Score was 15. The total length of stay due to injuries over the study period was 514 days and was estimated for the local economy downfall of 285,000 Sadi Riyals as a cost of hospitalization. Twenty-six (25.4%) patients had to be readmitted to the hospital due to various complications. Thirty-seven (36.3%) patients had long-term disability. The mean length of stay in the hospital was 5 days (range = 1–9 days). The length of stay was positively correlated with Injury Severity Score, and significant increase was identified when the patients had ISS more than 20 (p < 0.04).ConclusionThe results from this study support the current tight gun law regulations in Saudi Arabia, which aims to reduce the number of firearm-related morbidity and mortality in the society. There is a necessity for better education in Saudi Arabian communities in relation to firearms and their use in order to reduce the number of firearm accidents and related injuries.

Management of the scrotal trauma caused by an air-compressed gun in a child: A case report

Children exposed to air gun pellets may also have a different clinical picture, from mild tissue damage to life-threatening injury. Although these weapons are known as toys, in recent years, there has been a significant increase in the muzzle velocity of these weapons with advances in gas technology. Air gun injuries are frequently presented in the head, neck and thorax region, but injuries in the genitourinary tract are rare in children. Here, we report a 12-year-old boy who was injured by a random shot with an air gun, due to the features of his diagnosis and treatment.

An Unusual Foreign Body Within the Pterygopalatine Fossa: A Case Report

Air gun injuries normally present with a wide variety of clinical forms from minor to life-threatening injuries. The rare case of an air gun pellet retained in the pterygopalatine fossa has the risk of immediate or delayed haemorrhage as illustrated by our patient. Gunshot injuries must be considered as potentially life-threatening and raising awareness regarding its potential threats are required in order to minimize the air gun injuries, especially in children.

Air gun wound: bihemispheric penetrating brain injury in a paediatric patient.

Air guns are classified as low-velocity missiles and they usually considered safe and harmless. Despite that fact, air guns still can make serious or life-threatening injuries. Most of air gun injuries occur in paediatric population. A 2-year-old boy was shot in the forehead withan air gun accidentally. Skull radiography and non-contrast CT scan of the head were performed and showed penetrating bihemispheric brain injury from the left frontal to right occipital lobes at the level of the lateral ventricle with a metal-density foreign body at the right occipital. A projectile was successfully extracted via craniotomy, without complications. Air guns have the potential to cause fatal, life-threatening injury especially in children. Imaging is crucial for the evaluation of wound ballistics. Understanding about the mechanism of projectiles and wound ballistics is very helpful for radiologists to conceptualize these injuries when interpreting these cases. The role of radiology in ballistic wound cases is critical and important, both for clinical and forensic settings.

Image-guided percutaneous removal of ballistic foreign bodies secondary to air gun injuries.

Ballistic injuries with retained foreign bodies from air guns is a relatively common problem, particularly in children and adolescents. If not removed in a timely fashion, the foreign bodies can result in complications, including pain and infection. Diagnostic methods to identify the presence of the foreign body run the entire gamut of radiology, particularly radiography, ultrasound (US) and computed tomography (CT). Removal of the foreign bodies can be performed by primary care, emergency, surgical, and radiologic clinicians, with or without imaging guidance. To evaluate the modalities of radiologic detection and the experience of image-guided ballistic foreign body removal related to air gun injuries within the interventional radiology department of a large pediatric hospital. A database of more than 1,000 foreign bodies that were removed with imaging guidance by the interventional radiologists at our institution was searched for ballistic foreign bodies from air guns. The location, dimensions, diagnostic modality, duration, complications and imaging modality used for removal were recorded. In addition, the use of sedation and anesthesia required for the procedures was also recorded. Sixty-one patients with ballistic foreign bodies were identified. All foreign bodies were metallic BBs or pellets. The age of the patients ranged from 5 to 20 years. The initial diagnostic modality to detect the foreign bodies was primarily radiography. The primary modality to assist in removal was US, closely followed by fluoroscopy. For the procedure, 32.7% of the patients required some level of sedation. Only two patients had an active infection at the time of the removal. The foreign bodies were primarily in the soft tissues; however, successful removal was also performed from intraosseous, intraglandular and intratendinous locations. All cases resulted in successful removal without complications. Image-guided removal of ballistic foreign bodies secondary to air guns is a very effective procedure that can obviate the need for open surgical procedures in children.

Nonfatal air gun shot trauma: structural analysis and morphological features injuries

In practical activities of the Ukrainian bureau of forensic we increasingly come across cases of nonfatal air gun injuries. However, experts lack a common methodological approaches for forensic evaluation of injuries, particularly during the examination of living people. An earlier analysis of nonfatal air gun injuries made on materials of only two regional bureau of forensic medical examination, a purely local nature used on a small number of cases using some general parameters can provide processing methodology study of air gun injuries and practical recommendations for the implementation of forensic medical examinations. 127 cases of «Expert’s conclusions» and «Acts of the forensic examination» were investigated, taken from 21 bureaus all regions of Ukraine during the period of 2006-2015, in which was performed forensic medical examinations in cases nonfatal air guns injuries.Discussion. The main causes of nonfatal air gun injuries are named as hooliganism, domestic conflicts, careless handling of weapons and robbery. Among the injured men is 86 %, women – 14 %. Injuries made mostly of air pistols and rifles, caliber 4.5mm. Among the weapons 8 models applied rifles large and extra large capacity. Most commonlywounded parts were head (38 %), chest (17,3 %) and lower limbs (16 %), less common – upper limbs (10,2 %) and neck (3,9 %). Input air gun injuries are mainly wounds (74 %), sometimes abrasions (23 %) and bruising (3 %). The nature and volume air gun injuries primarily dependent on the power of the applied weapon and the affected areas of the body, penetrating wounds from shots of powerful guns are accompanied by injuries of the brain and spinal cord, internal organsof the chest and abdomen bleedings, fractures of the skull, vertebrae, ribs and scapula; of shots from pistols and rifles low penetrating injuries were observed only in the cranial cavity, mostly after bullet passing an eyeball.Conclusions:1. The main causes of nonfatal air gun shot trauma were hooliganism, domestic violence, accidents and robberies. Among the casualties men is 86 %, women – 14 %.2. Injuries made mostly of air pistols and rifles, caliber 4.5mm including extra large power rifles.3. Most cases provided head, chest and lower limbs wounds, fewer cases of upper limbs and neck injuries were observed.4. High and extra large power rifles more caused penetrating air gunshot wounds of major body cavities with injury to the brain and spinal cord, internal organs with hemorrhages and bone fractures. Pistols and low power rifles caused penetrating injuries only in the cranial cavity, commonly after passing projectile eyeball.5. The majority of wounds are defined as minor injuries. Injuries of moderate severity made up only 2%. Serious injuries attributed to 13% according hazard to life and complete loss of sight.

Epidemiology of Sports-Related Eye Injuries in the United States

ImportanceOcular trauma can lead to lifelong sequelae, and sports-related ocular injuries have been shown to disproportionately affect the young. Studies quantifying and characterizing the incidence and type of injuries seen with sports-related ocular trauma may be useful for resource utilization, training, and prevention efforts.ObjectiveTo examine the emergency department (ED) burden of sports-related ocular trauma in the United States.Design, Setting, and ParticipantsThis retrospective, cross-sectional study examined the Nationwide Emergency Department Sample, containing data from approximately 30 million ED visits annually at more than 900 hospitals nationwide, from January 1, 2010, to December 31, 2013, to determine factors associated with sports-related ocular trauma.Main Outcomes and MeasuresAnnual incidence of sports-related ocular trauma, broken down by age, sex, mechanism of injury, and related activity, as well as factors associated with short-term impaired vision. ResultsDuring the study period, 120 847 individuals (mean age, 22.3 years [95% CI, 21.9-22.7]; 96 872 males, 23 963 females, and 12 with missing data) presented with sports-related ocular trauma, which was the primary diagnosis in 85 961 patients. Injuries occurred most commonly among males (69 849 [81.3%]; 95% CI, 80.6%-81.9%) and occurred most frequently as a result of playing basketball (22.6%; 95% CI, 21.7%-23.6%), playing baseball or softball (14.3%; 95% CI, 13.7%-14.9%), and shooting an air gun (11.8%; 95% CI, 10.8%-12.8%). Odds of presentation to the ED with impaired vision were greatest for paintball and air gun injuries relative to football-related injuries (odds ratio, 4.75; 95% CI, 2.21-10.19 and 3.71; 95% CI, 2.34-5.88, respectively; P < .001).Conclusions and RelevanceIn our study, approximately 30 000 individuals presented annually to EDs in the United States with sports-related eye injuries; in more than 70% of these cases, eye injuries were the primary diagnosis. Activities involving projectiles pose the greatest risk for visual impairment in the short term, although long-term outcomes were unavailable.

Medico-Legal Issues in Air Gun Injuries

Introduction: The only difference of airgun with rest of firearms is it propels projectile by means of compressed air. Air gun injuries are uncommon in Sri Lanka as it is not commonly used. However, it seems to be promoting since recently. There are no laws related to air guns and anybody can buy for the purpose of hunting and a license is not needed. Case report: An 8 year old boy was admitted with an injury to the right hand. According to father, the injury was due to an accidental fall. There was a circular shape 3 mm perforated laceration with 5 mm abraded margin at the base of right palm. However, there were no evidence of burning, blackening or tattooing. X-ray examination revealed a dumbbell shaped radio-opaque foreign body in the right wrist damaging the epiphysis of the radius. A metallic foreign body was surgically removed. Later, it was revealed that the child received injuries while playing with one of his relative children with an air gun. Conclusions: The findings were compatible with injuries caused by an air gun. Although air guns can be used in meaningful manner, it is dangerous in children’s hands. Though no reported fatal cases in Sri Lanka, they can be modified and use for dangerous purposes. Therefore, it is recommended to develop regulations and control on air guns.

Letter to the Editor: Air-gun pellet injuries to the head and neck: what are the mechanisms of injury and optimal steps in management?

Letter to the Editor: Air-gun pellet injuries to the head and neck: what are the mechanisms of injury and optimal steps in management?

Atypical Gunshot Injury to the Ear: A Case Report

Bullet injuries to head and neck are usually associated with high mortality and morbidity due to a number of vital structures lying in close proximity. We present a rare case of air-gun injury with an unusual entry wound. The pellet having a simple trajectory was lodged into middle ear avoiding all important structures.