RESUMEN
Background: An improvised air gun with marble bullets, locally known as "Jolen Gun", is a type of home-made gun using Polyvinyl chloride (PVC) pipes and compressed air. It is mainly being used as a hunting tool in Central Mindanao. This "non-lethal" weapon has the potential in causing serious harm. There has been several incidents of minor injuries from this type of weapon in our institution but this is the first documented case of an improvised marble air-gun causing significant injury to the patient. Case report: A child was brought to a rural tertiary center after being shot in the chest using an improvised gun with marble as bullet. On evaluation, the patient had a single gunshot wound approximately 2cm x 2cm in size on the posterior chest at the right paravertebral area of the 4th thoracic vertebra. There was no exit wound noted. Chest CT done showed a rounded radiopaque foreign body seen in the right upper lung field with gunshot fracture involving the posterior aspect of the 4th rib. There was also pulmonary contusion of the right upper lobe and a fluid density at the right posterior pleural space attributed to a hemothorax. Open thoracotomy, removal of foreign body, repair of lung injury and debridement was done. Patient had an unremarkable post-operative course and was subsequently discharged. Conclusion: After extensive search of both local and international literatures, this appears to be the first case involving a penetrating chest injury from an improvised marble air-gun which has been treated successfully. Although this is a low-energy type of weapon, it still has the potential to cause significant harm to the body. Relevant laws should be made to against the use of this type of weapon to prevent similar injuries in the future.
