A 3-year-old boy was referred from Kolkata with history of accidental air gun bullet injury. The child presented at Apollo Children’s Hospitals with an entry wound in the right chest. On evaluation, X-ray report revealed a bullet lodged on the right paraspinal region.
The parents were concerned; about the damage a bullet can cause to the internal organs of their child. Child was hemodynamically stable and was admitted for removal of bullet. Further workup and routine blood investigations were done with a CECT of the abdomen.
A team of Doctors from Apollo Children’s Hospitals comprising of Dr. Prakash Agarwal, Dr. R. K. Bagdi and Dr. Jegadeesh, Consultant Pediatric Surgeons planned for a diagnostic laparoscopy and removal of the bullet. As CECT showed, the bullet was lodged anterior to the right renal hilum, anterior to the Inferior Vena Cava.
Laparoscopy showed the trajectory of the bullet where it had pierced through the liver and come out through the caudate lobe of liver and was lying in front of the hilar region of kidney. The entire procedure took around 30 minutes, without any blood loss. Child made a remarkable recovery and was discharged the next day in less than 24 hours.
This is the first time in India that a penetrating bullet injury is being removed by laparoscopy in a child. Otherwise with a laparotomy, the child would have had to stay in the hospital for 4-5 days with further morbidity.
Parents were very thankful that the team of doctors could manage such a complicated case so efficiently without any complications.
