Detection and Successful Treatment of Gunshot Wound to the Femoral Artery and Vein Four Days Post-incident: A Case Study

This case study presents the successful treatment of a 26-year-old male who experienced profuse bleeding from a gunshot wound to his thigh 4 days after the initial injury. The patient underwent surgery performed by a military vascular surgeon, during which previously undetected injuries to the femoral artery and vein were identified. The surgeon conducted a femoral artery alloprosthesis and sutured the damaged femoral vein. Following the surgery, the patient received post-operative conservative treatment and vacuum-assisted closure therapy, resulting in no complications or development of irreversible ischemic manifestation. The clinical case demonstrates the possible positive effects of placing an endovascular balloon in the main artery (more proximal lesion) for prolonged bleeding control without the use of a tourniquet. In this case, the role of the endovascular balloon was played by a hematoma. As a result, the lower extremity survived 4 days before the arterial blood flow reconstruction was done. Although such a model of bleeding control is absolutely unacceptable for planned specialized surgery or even military surgery at a medical assistance level of II-III, it may be considered as a lifesaving measure when surgical intervention is not immediately available.