Intracardiac shrapnel in a polytraumatized child

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Pediatric Surgery

Background:

• Penetrating cardiac trauma poses significant surgical challenges, especially with associated multiple organ injuries.
• War-related injuries frequently involve complex trauma, complicating patient management.
• Prompt surgical intervention is critical for survival in severe cardiac trauma cases.

Observation:

• A 9-year-old female sustained severe injuries from an unexploded artillery shell.
• The patient presented with a retained intracardiac shrapnel lodged in the interventricular septum.
• Associated injuries included pneumopericardium and right-sided hemopneumothorax.

Findings:

• Surgical removal of the intracardiac shrapnel was successfully performed.
• Management of the pneumopericardium and hemopneumothorax was addressed concurrently.
• The patient's complex cardiac and thoracic injuries were successfully treated.

Implications:

• This case highlights the feasibility of surgical repair for complex intracardiac foreign bodies in pediatric trauma.
• Successful management underscores the importance of a multidisciplinary approach in high-velocity penetrating trauma.
• The report provides valuable insights into surgical strategies for rare pediatric cardiac injuries in combat settings.