Air guns are known as low-velocity arms and are considered harmless. However, injuries from air weapons can be serious and even fatal, particularly in children. We present a potentially life-threatening penetrating retroperitoneal injury of a 3-year-old boy caused by an air gun, and the successful removal of the bullet via a laparoscopic approach. The patient was brought to our center with a penetrating air gunshot wound on his right side in the waist area. He was accidentally shot by his brother at their home. The patient’s clinical condition was stable. Computed tomography scan showed the bullet in the retroperitoneum near the inferior vena cava. A three-port laparoscopic transperitoneal approach was performed. The bullet was found just 0.5 cm caudal to the right renal hilum and 0.5 cm near the inferior vena cava; it was then removed. Operation time was 42 min and the postoperative course was uneventful. Thanks to improvements in laparoscopic surgical techniques, laparoscopy has become a feasible and effective treatment modality even for the removal of foreign bodies in children.

1.
Milroy CM, Clark JC, Carter N, Rutty G, Rooney N: Air weapon fatalities. J Clin Pathol 1998;51:525–529.
2.
Ceylan H, McGowan A, Stringer MD: Air weapon injuries: a serious and persistent problem. Arch Dis Child 2002;86:234–235.
3.
Brown SL, Elder JS, Spirnak JP: Are pediatric patients more susceptible to major renal injury from blunt trauma? A comparative study. J Urol 1998;160:138–140.
4.
Dissanaike S, Griswold JA, Frezza EE: Treatment of isolated penetrating flank trauma. Am Surg 2005;71:493–496.
5.
Lu XH, Lu ZJ, Hu J, Song JX, Chen SL: Bullet migration from the knee to the heart after a gunshot injury: a case report. Chin Med J (Engl) 2011;124:1590–1592.
6.
Raz O, Shilo Y, Stav K, Leibovici D: Late migration of a retained bullet into the urinary bladder presenting with acute urinary retention. Isr Med Assoc J 2007;9:484–485.
7.
Cağavi F, Kalayci M, Seçkiner I, Cağavi Z, Gül S, Atasoy HT, Demircan N, Açikgöz B: Migration of a bullet in the spinal canal. J Clin Neurosci 2007;14:74–76.
8.
Oomen JW, Smits BW, Swinkels DW, Schreurs BW, Bloem BR, Hendriks MP: A toxic shot from the hip. J Neurol Neurosurg Psychiatry 2011;82:353–354.
9.
Coon T, Miller M, Shirazi F, Sullivan J: Lead toxicity in a 14-year-old female with retained bullet fragments. Pediatrics 2006;117:227–230.
10.
DuBose J, Inaba K, Teixeira PG, Pepe A, Dunham MB, McKenney M: Selective non-operative management of solid organ injury following abdominal gunshot wounds. Injury 2007;38:1084–1090.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.