Navigating the complexity of spinal cord injuries with retained foreign bodies and the diagnostic challenge of lead toxicity-a case reportaaa.
Journal
Spinal cord series and cases
ISSN: 2058-6124
Titre abrégé: Spinal Cord Ser Cases
Pays: England
ID NLM: 101680856
Informations de publication
Date de publication:
23 Apr 2024
23 Apr 2024
Historique:
received:
11
06
2023
accepted:
11
04
2024
revised:
09
04
2024
medline:
24
4
2024
pubmed:
24
4
2024
entrez:
23
4
2024
Statut:
epublish
Résumé
Retained shrapnel from gunshots is a common occurrence; however, retained shrapnel within the spinal canal is exceedingly uncommon. Guidelines for removal and treatment of these cases are a difficult topic, as surgical removal is not necessarily without consequence, and retention can lead to possible further injury or a secondary disease process of plumbism, which can be difficult to diagnose in this population. This case report provides a unique example of a young patient with retained shrapnel from a gunshot. This patient suffered an initial spinal cord injury due to a gunshot and secondarily presented with abdominal pain, fatigue, elevated blood lead levels, and was diagnosed with plumbism. This was addressed with operative removal of shrapnel and posterior instrumented spinal fusion, resulting in decreased lead levels and symptom resolution postoperatively. Lead toxicity risk in patients with retained shrapnel, particularly in the spine, warrants vigilant monitoring. While management guidelines lack consensus, symptomatic lead toxicity may necessitate intervention. Residual neurological deficits complicate evaluation, emphasizing individualized management decisions.
Identifiants
pubmed: 38653970
doi: 10.1038/s41394-024-00640-7
pii: 10.1038/s41394-024-00640-7
doi:
Substances chimiques
Lead
2P299V784P
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
28Informations de copyright
© 2024. The Author(s), under exclusive licence to International Spinal Cord Society.
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