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Case Report
Transected popliteal artery via gunshot wound: A case report
1 General Surgery Resident, Trauma, HCA Florida Brandon Hospital/USF Morsani College of Medicine, Brandon, FL, USA
2 Trauma Attending, Trauma, HCA Florida Blake, Bradenton, FL, USA
3 Vascular Surgery Attending, Vascular Surgery, HCA Florida Brando, Brandon, FL, USA
Address correspondence to:
Trina Capelli
119 Oakfield Drive Brandon, FL 33511,
USA
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Article ID: 100125Z12TC2023
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Capelli T, Rusli E, Abbruzzese T. Transected popliteal artery via gunshot wound: A case report. J Case Rep Images Surg 2023;9(2):22–26.ABSTRACT
Introduction: Popliteal artery transection is an uncommon injury but can be seen in traumas like gunshots, stabs, and complex fractures of the distal femur or proximal tibia. Although uncommon, these injuries carry the greatest risk of limb loss of any peripheral vascular injury. Timely hemostasis and repair are crucial to limb-salvage and overall survival, as lower extremity amputation is known to have very high mortality rates. We present a multiple gunshot wound patient who was found to have a completely transected popliteal artery injury and who underwent open surgical repair with interposition vein graft using the greater saphenous vein, ultimately resulting in two-vessel runoff and limb salvage.
Case Report: A 30-year-old man with no known past medical history presented to the hospital via private vehicle after being shot multiple times just prior to arrival. Obvious injuries noted were two gunshot wounds to the left hand with hemorrhage, two gunshot wounds to the right thumb without hemorrhage, one gunshot wound to the left upper quadrant, one gunshot wound to the left flank, and one to the right lower extremity in the posterior distal thigh with massive hemorrhage. He was emergently taken to the operating room where exploration of the right popliteal artery and vein was performed which revealed a completely transected popliteal artery. The bullet was found to be lodged in the distal femur. The left great saphenous vein was then harvested in order to use it to repair the right popliteal artery with an interposition vein bypass. Intraoperative angiogram confirmed 2-vessel runoff. A four-compartment fasciotomy was performed prophylactically to avoid compartment syndrome. Postoperatively, the patient was extubated on post-op day 1. On post-op day 7, he was transferred out of the ICU and underwent split thickness skin grafting to the right lower extremity fasciotomy wounds. On post-op day 18, he was discharged home with a walker and the ability to move all extremities. He has now recovered full ambulatory function.
Conclusion: Transection of popliteal artery should be considered in trauma patients with profuse lower extremity bleeding. In severe injuries and hemodynamically unstable patients, prompt hemostasis should be achieved and open surgical repair with an interposition vein graft should be considered for limb salvage.
Keywords: Gunshot wound, Popliteal artery, Trauma surgery, Vascular surgery
SUPPORTING INFORMATION
Author Contributions
Trina Capelli - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Erwin Rusli - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Thomas Abbruzzese - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
AcknowledgmentsThe authors thank Dhruv Patel for contributing to the work of this case report.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Trina Capelli et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
