%0 Journal Article
%T Penetrating injury to the chest by an attenuated energy projectile: a case report and literature review of thoracic injuries caused by "less-lethal" munitions
%A Joao Rezende-Neto
%A Fabriccio DF Silva
%A Leonardo BO Porto
%A Luiz C Teixeira
%A Homer Tien
%A Sandro B Rizoli
%J World Journal of Emergency Surgery
%D 2009
%I BioMed Central
%R 10.1186/1749-7922-4-26
%X Currently, crowd control is ideally enforced by a trained police force using "less-lethal" tactics and weapons. Previous reports of serious injuries and even deaths, caused by hard rubber bullets, have prompted the development of safer, attenuated energy rounds [1-3]. Examples include the plastic baton rounds and the more recent attenuated energy projectile. These rounds represent safer options than the original rubber bullets and are currently used by many different police forces.We report a rare case of a penetrating injury to the chest caused by an attenuated energy projectile. We then review the historical development and injury literature surrounding rubber and plastic "less-lethal" impact munitions.A 24-year-old male was shot in the right hemithorax by an attenuated energy projectile (AEP), fired from a 12-gauge shotgun at close range (less than 3 m). He arrived to our Trauma Center approximately 36 hours after the injury. He presented with a fever, had decreased breath sounds on the right side, and his vital signs were stable (pulse was 100, blood pressure was 140/90 mmHg. Physical examination revealed a single skin laceration (2.0 cm) with surrounding contusion at the right mid-axillary line; 4th intercostal space. The admission chest radiograph revealed a small right pneumothorax, pulmonary contusion and radiopaque material within the right middle lobe (Figure 1). A right-sided thoracostomy tube drained minimal air and blood. A computed tomography (CT) scan of the chest demonstrated a foreign body in the right hemithorax with the form of an AM-403/P attenuated energy projectile (Figure 2). Due to septic complications and the size of the foreign body, the patient underwent a right thoracotomy which revealed a 19 g (6.5 กม 2.5 cm) projectile within the middle lobe, which was surrounded by an intra-parenchymal hematoma (Figure 3). The projectile and injured parenchyma were removed by wedge resection. The patient had an uneventful hospital stay and was discharge
%U http://www.wjes.org/content/4/1/26