Surgical removal of an impaled unexploded mortar shell into the chest: Case review from a war-zone

Authors

Zakarya Mothanna, Department of Orthopedy, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.
Mohamed Badheeb, Internal Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, USA.Follow
Faisal Ahmed, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen. Electronic address: fmaaa2006@yahoo.com.Follow
Saleh Al-Wageeh, Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.Follow
Taha Al-Mwald, Department of Radiology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.Follow
Saif A. Ghabisha, Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen.Follow

Document Type

Article

Publication Title

International journal of surgery case reports

Abstract

INTRODUCTION AND SIGNIFICANCE: The surgical removal of unexploded mortar shells is rarely documented in the literature. Since most cases occur within war or conflict regions, reporting such instances is vital for optimizing and enhancing surgical practices, particularly in low-resource settings. CASE PRESENTATION: We report the case of a 35-year-old man who sustained an injury from a 60 mm unexploded mortar shell, penetrating the patient's right posterior chest in the right paravertebral region of the 4th thoracic vertebra, causing intrathoracic injuries, multiple rib fractures, and a right pneumothorax. The patient was immediately resuscitated and transferred to the operating room. The projectile was removed without direct contact with metal instruments. A right chest tube was then inserted and the injured area was repaired, resulting in an uneventful postoperative recovery. CLINICAL DISCUSSION: Unexploded mortar shell injuries are infrequently documented in the literature. These injuries are seen within war and conflict regions, that have limited accessibility or availability of experienced explosive ordnance disposal (EOD) teams, transporting personnel, and equipped and separated operating theaters. CONCLUSION: Unexploded ordnance and munitions represent an underrecognized and underreported health risk to patients, healthcare providers, and healthcare facilities. These injuries are commonly encountered within regions that lack experienced transport and EOD staff. The need for the establishment of such experienced teams along with providing adequate training for healthcare providers is necessary.

First Page

109967

DOI

10.1016/j.ijscr.2024.109967

Publication Date

8-1-2024

Recommended Citation

Mothanna, Zakarya; Badheeb, Mohamed; Ahmed, Faisal; Al-Wageeh, Saleh; Al-Mwald, Taha; and Ghabisha, Saif A., "Surgical removal of an impaled unexploded mortar shell into the chest: Case review from a war-zone" (2024). Internal Medicine. 18.
https://scholar.bridgeporthospital.org/internal_medicine/18

Identifier

38943933 (pubmed); PMC11261394 (pmc); 10.1016/j.ijscr.2024.109967 (doi); S2210-2612(24)00748-X (pii)