Thoraco-abdominal gunshot wound in pregnancy: a case report from the departement of general surgery Conakry teaching hospital

Abstract

 The objective was to report the clinical observation of a ballistic thoracoabdominal and uterine wound on pregnancy 
with maternal fetal survival.
 Observation : It was a 16-year-old primigravida, referred for a thoracoabdominal ballistic wound. On arrival, she was in hemorrhagic shock with an epiploid fringe coming out through the abdominal wall (fig 1). Examinations (gynaecological-obstetrical and ultrasound) showed a progressive pregnancy of 25 SA. Chest X-ray showed a right hemothorax and the presence of the projectile (bullet) in the right hemithorax. Foreign bodies were noted on the x-ray film of the abdomen without preparation. The projectiles thus caused a penetrating thoracic wound with right hemothorax, two abdominal parietal wounds, one of which was penetrating with evisceration and wound of the pregnant uterus. The surgical procedures were right thoracic drainage. Laparotomy showed a discrete hemoperitoneum and a visible metal fragment in the uterine wall which we extracted followed by toilet. A tocolysis was performed, ordered by the gynaecologists. The parturient and her fetus are progressing favorably.
Conclusion: The prognosis depends on the severity of the lesions and the delay in management.