Decade Later Presentation of an Intraosseous Metallic Foreign Body in the Pelvis: A Case Report and Literature Review.

ABSTRACT

Introduction: Metallic foreign body reactions are observed many times, usually in the early periods. However, late presentations are often uncommon. Management of these foreign bodies varies from a military setting to a civilian setting where saving a patient's life is the priority. Case Report In this case report, we present a 49-year-old soldier with recent onset swelling in the right gluteal region with elevated local temperature and minimal tenderness. The patient suffered a land mine blast injury 10 years ago with multiple injuries to the chest, abdomen, and lower limb. According to military protocols, he was initially managed for life-threatening chest and open abdominal injuries. The right lower limb was non-salvageable and underwent above-knee amputation. A dormant metallic foreign body, which was retained inside the right iliac bone, presented a decade later with a subacute non-pyogenic abscess. Conclusion: The primary goal in military injuries is always to save a patient's life. While acute management remains the same for both military and civilian injuries. In military injuries, deep-seated, inactive foreign bodies are often left behind in order to avoid fresh plane dissection, and to minimize blood loss for early stabilization and save patient lives. Late-onset inflammatory responses are the cause of the delayed presentation of retained foreign bodies.