PMC9813523_01
Illustration of the intraoperative view of the left superficial femoral artery. A. The overall view of the patient at admission shows surgical clamps fixed within the gunshot wound in the upper 1/3 of the left femur (marked with a rectangle). B. Functioning temporary arterial shunt (marked with arrow) of the left superficial femoral artery.
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At admission to Level II, the patient was diagnosed with a gunshot injury to the left superficial femoral artery (SFA) with complete rupture and underwent primary surgical debridement of the wounds as well as temporary arterial shunting (Fig. 1).
Photo of the intraoperative view of the right popliteal artery injury. A. The overall view of the patient at admission shows an inlet hole within the area of the right knee (marked with a rectangle). B. The right popliteal artery edges were fixed with two elastic bands, and the injured part is marked with an arrow. C. Right popliteal artery after the reconstruction with a saphenous vein graft.
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Further revision showed moderate venous bleeding from the inlet and outlet gunshot wounds in the area of the right knee (Fig. 2). At revision, we found bleeding from both a partially damaged right popliteal artery and a branch of a right popliteal vein (Fig. 2).
Intraoperative view of the functioning temporary arterial shunt for left superficial femoral artery (marked with an arrow) as found at revision in the hospital of Level IV.
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At further revision, the temporary arterial shunt of the left SFA was fully functioning (Fig. 3).
Illustration of the bullet as a methal-density object on X-ray film (marked with a circle) in the area of the right hip and its presentation after removal.
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An X-ray showed the presence of a metal-density object (i.e. bullet) within the area of the right hip (Fig. 4).