A Giant Foreign Body due to Rocket Explosion

A 25-year-old soldier presented to the emergency department with a right scapular injury caused by a rocket explosion during a terrorist attack. The attack occurred while the patient was driving an armored vehicle. Upon physical examination, a skin and muscular defect measuring 5×1.5 cm in the right scapular region near the shoulder was observed. A right shoulder roentgenogram revealed a giant metallic foreign body measuring 11×2.5 cm, which was parallel to the humerus (Figure 1). The right humerus was intact. A lung roentgenogram presented normal findings. Doppler ultrasonography indicated no vascular injury to the affected site. The patient underwent surgery, and the metallic foreign body was removed from the body (Figure 2). The patient was discharged after a 2-day hospital stay.

Figure 1.

A right shoulder roentgenogram revealed a giant metallic foreign body and small pieces of shrapnel between the humerus and scapula.

Figure 2.

The foreign body was removed from the patient’s body via a 3-cm surgical incision.

The shape of this type of injury is generally related to the weight, type and power of the explosive. In this case, the rocket shrapnel was extraordinarily large, but the injury itself was not particularly harmful. A search of related literature indicated that extremity injuries are observed in over 70% of all rocket- and missile-related injuries, with the upper extremity injured in 35% of all injuries of this type [1, 2].