Ingestion of Metallic Shrapnel by a Bomb-blast Victim: A Case Report and Literature Review

This case report describes an unusual incidence of shrapnel ingestion by a bomb-blast victim with infliction of multiple, simultaneous, penetrating injuries.Consequently, the foreign body that appeared within the lumen of cecum on the computed tomography (CT) scan was thought to have entered through one of these penetrating injuries. A 31-year-old male, who was the victim of a bomb-blast, was brought to the emergency room with multiple, penetrating wounds. The CT scan of the abdomen showed a dense metallic body within the cecum but cecal perforation was not ruled out. Exploratory laparotomy revealed a metallic body within the lumen of the cecum with no gut perforation. The metallic foreign body, which was actually ingested shrapnel, subsequently passed out in the stools. Even with the use of high-tech investigations and diagnostic tools, the clinician was unable to reach a conclusive diagnosis. Therefore, the importance of a thorough and detailed clinical history and physical examination and their interpretation should not be underestimated, and physicians should be open to a wide variety of possible causes.