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Spinal Cord Ser Cases ; 10(1): 28, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38653970

RESUMO

INTRODUCTION: Retained shrapnel from gunshots is a common occurrence; however, retained shrapnel within the spinal canal is exceedingly uncommon. Guidelines for removal and treatment of these cases are a difficult topic, as surgical removal is not necessarily without consequence, and retention can lead to possible further injury or a secondary disease process of plumbism, which can be difficult to diagnose in this population. CASE PRESENTATION: This case report provides a unique example of a young patient with retained shrapnel from a gunshot. This patient suffered an initial spinal cord injury due to a gunshot and secondarily presented with abdominal pain, fatigue, elevated blood lead levels, and was diagnosed with plumbism. This was addressed with operative removal of shrapnel and posterior instrumented spinal fusion, resulting in decreased lead levels and symptom resolution postoperatively. DISCUSSION: Lead toxicity risk in patients with retained shrapnel, particularly in the spine, warrants vigilant monitoring. While management guidelines lack consensus, symptomatic lead toxicity may necessitate intervention. Residual neurological deficits complicate evaluation, emphasizing individualized management decisions.


Assuntos
Corpos Estranhos , Intoxicação por Chumbo , Traumatismos da Medula Espinal , Ferimentos por Arma de Fogo , Humanos , Masculino , Corpos Estranhos/complicações , Corpos Estranhos/cirurgia , Chumbo/sangue , Intoxicação por Chumbo/diagnóstico , Intoxicação por Chumbo/etiologia , Traumatismos da Medula Espinal/diagnóstico , Fusão Vertebral/métodos , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/cirurgia , Criança
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