Projectile Injury Near the Brachial Plexus

Boussaidane M, B. J, C. B, Benchebba D, Boussouga M
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Abstract

We report the case of a young 36-year-old rider with no notable pathological history, victim of an explosion from the fire fighting (black powder chamber) of his rifle when firing during the celebrations of TBOURIDA (ancient equestrian art, dating from the 15th century It is an equestrian representation which simulates a succession of military parades, reconstituted according to ancestral Arab-Amazigh conventions and rituals), Causing the departure of projectile (percussion lock); with impact point on the front of the right shoulder. The examination at the emergency room admission 30 minutes from the accident found a conscious patient, stable hemodynamic state, normal breathing, the inspection objected a wound of 15mm in diameter at the level of the right deltopectoral groove, without an opening exit (Figure 1). The vasculo-nervous examination of the right upper limb was normal. The standard x-ray showed the presence of a foreign body between the glenohumeral joint and the rib cage (Figure 2), the chest CT scan with injection of the contrast product revealed the foreign body located one centimeter from the axillary artery, without lung lesions (Figure 3).
臂丛附近的弹射伤
我们报告了一名36岁的年轻骑手,没有明显的病理病史,在TBOURIDA庆祝活动(古代马术艺术,可追溯到15世纪,这是一种模拟连续阅兵式的马术表演,根据祖先阿拉伯-阿马齐格的习俗和仪式重组)中射击时发生火灾(黑色火药室)爆炸的受害者,导致弹丸(冲击锁)离开;弹着点在右肩前方。事故发生30分钟后急诊室入院检查发现患者意识清醒,血流动力学状态稳定,呼吸正常,检查发现右胸三角沟处有直径15mm的伤口,无开口出口(图1)。右上肢血管神经检查正常。标准x线片显示肱骨盂关节与胸腔之间存在异物(图2),注射造影剂的胸部CT扫描显示异物位于距腋窝动脉1厘米处,未见肺部病变(图3)。
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