Terrorist Bombings: Foreign Bodies from the Boston Marathon Bombing

Brunner, John; Singh, Ajay K.; Rocha, Tatiana Carneiro da; Havens, Joaquim M.; Goralnick, Eric; Sodickson, Aaron

doi:10.1053/j.sult.2014.10.006

Cited by 19 publications

(10 citation statements)

References 12 publications

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“…Moreover, as mentioned in cases 8 and 9, due to the rising number of refugees and the transfer of seriously injured patients from combat zones, as well as the increase in global terroristic attacks, special attention should be paid to injuries caused by destructive weapons and explosives. 9 In most cases, foreign bodies were associated with minor trauma, including small lacerations or open wounds, although foreign body injuries may also be severe, as demonstrated in some of our cases. In general, injuries of the head and neck are potentially life-threatening depending on the location and extent of penetration of the foreign body.…”

Section: Discussionsupporting

confidence: 53%

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Voß

Thieme

Doll

et al. 2018

Craniomaxillofacial Trauma & Reconstruction

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Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions. Blast injuries resulting from terror attacks are challenging recent therapeutic concepts. Even though these injury patterns are uncommon, they carry the risk of impacted objects with dramatic consequences. Despite improving medical imaging techniques, detection remains a challenge as it is dependent on the material of the foreign body, the affected anatomical site, and the injury severity. Therefore, a detailed history of the circumstances leading to trauma is essential when foreign objects are not visible during clinical examination. Precise detection of the foreign body, its anatomical position, and the affected surrounding structures are vital, especially for impalement injuries of the head and neck area. Therefore, an interdisciplinary planning approach is essential prior to removal of the foreign object. Finally, tension-free anatomical adaptation of the corresponding structures is crucial for maintaining and restoring aesthetic and function. Here, we give an overview of the diagnosis and treatment of cases of foreign body injuries encountered in our department.

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Section: Discussionsupporting

confidence: 53%

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Voß

Thieme

Doll

et al. 2018

Craniomaxillofacial Trauma & Reconstruction

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“…No deep penetrating injuries to the abdomen or chest occurred as a result of the Boston Marathon bombing. The low power of these IEDs resulted in a predominance of secondary blast injuries, with ball bearings, nails, screws, and pieces of the pressure cooker housing acting as shrapnel (2,60,61). Of the 43 patients who underwent radiography in the emergency departments of three local hospitals, 32 had retained shrapnel in quantities ranging from one to 41 fragments per individual, with a total of 189 fragments (2).…”

Section: Radiologic Experience Of the Boston Marathon Bombingmentioning

confidence: 99%

Blast Injuries: From Improvised Explosive Device Blasts to the Boston Marathon Bombing

Singh¹,

Ditkofsky²,

York³

et al. 2016

RadioGraphics

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Although most trauma centers have experience with the imaging and management of gunshot wounds, in most regions blast wounds such as the ones encountered in terrorist attacks with the use of improvised explosive devices (IEDs) are infrequently encountered outside the battlefield. As global terrorism becomes a greater concern, it is important that radiologists, particularly those working in urban trauma centers, be aware of the mechanisms of injury and the spectrum of primary, secondary, tertiary, and quaternary blast injury patterns. Primary blast injuries are caused by barotrauma from the initial increased pressure of the explosive detonation and the rarefaction of the atmosphere immediately afterward. Secondary blast injuries are caused by debris carried by the blast wind and most often result in penetrating trauma from small shrapnel. Tertiary blast injuries are caused by the physical displacement of the victim and the wide variety of blunt or penetrating trauma sustained as a result of the patient impacting immovable objects such as surrounding cars, walls, or fences. Quaternary blast injuries include all other injuries, such as burns, crush injuries, and inhalational injuries. Radiography is considered the initial imaging modality for assessment of shrapnel and fractures. Computed tomography is the optimal test to assess penetrating chest, abdominal, and head trauma. The mechanism of blast injuries and the imaging experience of the victims of the Boston Marathon bombing are detailed, as well as musculoskeletal, neurologic, gastrointestinal, and pulmonary injury patterns from blast injuries.

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“…Shrapnel was detected in all these patients by X-ray or CT. SBIs were detected in 62/77 (80.5%) of the victims. In the literature review, SBI dominancy was found in open-space bombings [5,6,11,12]. The blast wind also propels people onto hard surfaces, causing blunt or tertiary injuries generally manifested as fractures [6,7,9].…”

Section: Discussionmentioning

confidence: 99%

Ankara bombing: distribution of injury patterns with radiological imaging

Parlak¹,

Beşler²

2020

Pol J Radiol

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Purpose: To describe and explain the blast injuries and imaging findings in the Ankara terrorist explosion that took place on October 10, 2015. Material and methods: A total of 77 patients who underwent radiologic imaging were classified as primary, secondary, tertiary, and quaternary, according to the injury type. The patients were evaluated based on body regions, such as head and neck, thorax, abdomen, lower extremity, and upper extremity. Results: Blast lung injury was identified in one patient and tympanic membrane perforation in seven patients, as the primary injury. Sixty-two of 77 patients had secondary blast injuries caused by shrapnel. The blast injuries were observed in the head and neck (16/77, 20.7%), thorax (11/77, 14.2%), abdomen (16/77, 20.7%), lower extremity (48/77, 62.3%), and upper extremity (5/77, 6.4%). Vascular injuries were seen in eight cases, of which seven were in the lower extremities. Conclusions: The most common blast injury pattern was of a secondary type in the current study. Lower extremities were the significantly more affected body region, probably due to the bomb exploding at ground level. In mass casualty events, radiologic imaging is located at the centre of patient management.

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Terrorist Bombings: Foreign Bodies from the Boston Marathon Bombing

Cited by 19 publications

References 12 publications

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Blast Injuries: From Improvised Explosive Device Blasts to the Boston Marathon Bombing

Ankara bombing: distribution of injury patterns with radiological imaging

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