38口径低速弾による銃創の1例

Abstract

A case of gunshot wound by 0.38 inch low-velocity bullet is reported. A 41 -year-old man was admitted to our hospital due to gunshot wounds. Three open wounds were recognized in the hip, right femoral region, and right lower leg on arrival. Also subcutaneous hematoma was found in the right femoral region. X-ray films on admission revealed a bullet in the right femoral region and injury of the femur bone. Pelvic CT scan revealed hematoma in the bladder and bullet fragments; however, no more associated injury was detected. Then, we diagnosed as non-penetrating wound through pelvic cavity and penetrating wound, entered from femoral region through lower leg. We removed the bullet and made debridement. The patient was discharged from our hospital on the 12th postoperative day and his postoperative course was uneventful. Since the bullet in this case was a 0.38 inch low-velocity bullet, it seemed that the degree of injury was not severe. Gunshot wound victims have been rarely seen in Japan, however, the system such as Advanced Trauma Life Support (ALTS) in the U.S.A should be established in Japan. Emergency physicians should know ballistics and gunshot wound management.