When air guns cause serious harm: multisystem involvement and the need for comprehensive care

Abstract

Aim of Study: To highlight the severity of air gun injuries in children, focusing on diagnostic challenges and the diverse therapeutic approaches required for varying injury types. Methods:This case series reviews five pediatric patients who sustained severe air gun injuries to different anatomical regions, including the chest, abdomen, and retroperitoneum. Diagnostic imaging and treatment strategies, ranging from conservative management to surgical interventions, were tailored to each case based on injury severity. Results:The injuries affected multiple anatomical areas and presented varying levels of complexity: • Chest injuries: Three children sustained thoracic injuries. One developed pneumothorax and subcutaneous emphysema, managed conservatively due to a retained bullet near the vertebral column. Another suffered a cardiac injury causing asystole, successfully managed with emergency sternotomy. The third child’s lung injury, causing minor pneumothorax, was treated with thoracoscopy and conservative care. • Abdominal injuries: One child required laparotomy for injuries to the liver, stomach, and pancreas. Months later, a migrating kidney bullet caused ureteral obstruction, resolved with stenting and cystoscopic removal. • Retroperitoneal injuries: A lumbar wound caused a retroperitoneal hematoma and ureteral damage, managed with drainage and stenting, leading to full recovery. Conclusions: Air guns can cause diverse and severe injuries across multiple anatomical regions, necessitating a range of diagnostic and therapeutic strategies. Prompt and tailored management is critical for positive outcomes. Public awareness and stricter regulations are essential to prevent such incidents.