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Air-gun pellet at C1: a case report and literature review
Norah Ibrahim Alromaih1, Hani Nouran Alharbi1, Nouf Abdulaziz Altwaijri1
1Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Saudi Arabia.
Insights
Air-gun pellet injuries can be serious, but a C1 spinal foreign body in a child was successfully managed conservatively. This case highlights the potential for non-surgical treatment in pediatric spine injuries from air guns.
Area of Science:
- Pediatric Traumatology
- Neurosurgery
- Emergency Medicine
Background:
- Air-gun pellet injuries are common in children and can affect vital organs.
- Spine injuries from air-gun pellets are rarely reported in medical literature.
- This case involves a C1 foreign body in a pediatric patient following an air-gun injury.
Background:
Air-gun pellet injuries commonly occur in children between the age of 1-18 years old. These injuries could be fetal because it linked to injury to vital organs such as brain, heart, and eyes. In the literature, there are few studies that reported spine injury by air-gun pellet. Our case is a C1 foreign body in a pediatric patient without any neurological deficits after an air-gun injury.
Case Description:
A 6-year-old boy, known case of Hirschsprung disease presented to the emergency department after an air-gun injury in June 2021. On examination, the patient was hemodynamically stable, and asymptomatic. Neurological exam was intact with power 5/5 in C5-S1 and sensation 2/2 in C5-S1. Computed tomography (CT) of the cervical spine showed a foreign body at C1. After discussing the treatment options with his parents, we treat the patient conservatively by close follow-up and analgesia only. After 1 week, the patient presented to the clinic and the patient was still asymptomatic. A cervical X-ray at that time done and showed no changes in the position from the initial CT. Weekly follow-up was difficult for the family to adhere to due to their socioeconomic status. Therefore, the patient was followed up over the phone call through telemedicine at 6 months and 1 year after the injury.
Conclusions:
The treatment of these types on injuries is highly controversial. The treatment options could be surgical or non-surgical (conservative) such as antibiotic use. Also, there is always a debate about the choice of the treatment options.
