The late effect of grenade fragments

Area of Science:

• Traumatology
• Gastroenterology
• Infectious Disease

Background:

• Retained metallic fragments from explosive devices can pose long-term risks.
• Surgical intervention for visceral perforation often leaves small fragments due to perceived low risk.
• Delayed complications from retained foreign bodies are uncommon but possible.

Observation:

• A patient presented with a psoas abscess 16 years after sustaining a grenade injury.
• The abscess was linked to a retained grenade fragment that had perforated the large bowel.
• Ultrasound imaging was crucial for locating the abscess and guiding aspiration.

Findings:

• A retained grenade fragment caused a delayed perforation of the large bowel.
• The perforation led to the formation of a psoas abscess.
• Ultrasound-guided aspiration of pus followed by antibiotic treatment was effective.

Implications:

• This case highlights the potential for late-onset complications from retained shrapnel.
• It underscores the utility of diagnostic ultrasound in managing complex abscesses.
• Antibiotic therapy, guided by imaging, can successfully treat such delayed sequelae.