Özet:
A fifty-four-year-old male patient presented to our emergency
department with a gunshot injury in his arm, caused by pellets.
Surgical exploration showed injury to the brachial artery,
which was then repaired with a saphenous vein graft.
Conservative treatment was planned for associated nerve
injuries. After arterial flow began, two pellet-like solid bodies
were palpated in the radial artery trace at the wrist level
and the pellets were removed from the lumen of the artery.
Ten days after surgery, the patient had profuse bleeding in the
arm. On exploration, partial necrosis was detected in the
saphenous vein graft and primary repair was performed.
H o w e v e r, on the 19th day, the bleeding recurred and
increased necrosis and rupture of the artery, 2-3 cm in size,
were detected. Arterial repair was repeated with another
saphenous vein graft from the other limb. The patient
returned to normal daily activities nine months after the
injury, with slight cold intolerance. Clinical examination and
Doppler studies did not show any signs of vascular deficiency.
Arterial or venous pellet embolism should be included in
the evaluation of patients with gunshot injuries.
