Doctors have treated a teenager in what is believed to be the first reported paintball related liver injury.
Writing in the latest edition of BMJ Case Reports, published today (6 May, 2016), doctors say that the 18-year-old was admitted to hospital with suspected appendicitis.
But when surgeons looked into his abdomen with a camera, they found extensive bleeding from the liver.
After the operation, the patient revealed he had been paintballing a couple of days earlier and said he had been hit twice on his right flank, although no bruising followed.
“This represents the first report of paintball related traumatic liver injury,” write the doctors, led by Dr Joshua Luck, from the North Middlesex University Hospital, London, UK.
"Organ injuries of this nature have only been documented three times previously," they add. In some of these cases, operations have been required to correct damage to the kidney, penis and scrotum.
"Participants and physicians must both be aware of the possible dangers associated with this sport," they conclude.
BMJ Case Reports also reports on warnings surrounding temporary black henna tattoos after a 10-year-old boy was treated for an allergic reaction.
Four days after having the tattoo while on holiday in Spain, the youngster suffered an outbreak of redness, itching, and small inflammatory irritated spots, believed to be caused by paraphenylenediamine (PPD), a textile dye that is commonly added to henna to blacken the pigment and speed up drying time.
"Skin tattoos with black henna should be avoided, especially during foreign travel, as this can make the tracing of the vendor and any subsequent public health management challenging," the doctors conclude.
A motorcyclist who was diagnosed with chronic exertional compartment syndrome (CECS) in his lower arm because of repeated braking manoeuvres on the racing track, the publication reports.
CECS usually develops in the legs but the rider, who treated at a hospital in the Netherlands, reported progressive weakness of his right index finger, and pain, weakness and swelling of his right forearm.
He underwent surgery to relieve the tension in the fascia and was treated for the resulting loss of circulation in the muscles of both his lower arms, but was back in training after six weeks and within three months was participating in higher level competitions again.
And BMJ Case Reports also reveals the injuries sustained by a 91-year-old former Second World War soldier who donated his body for medical education.
CT scans showed that the German man, who had been seriously wounded on the Eastern Front, had shrapnel fragments in both legs, as well as bone abnormalities. His multiple fractures and lesions had not been treated in the Austrian military hospital where he was taken, or in the French prisoner of war camp where he was subsequently held.
Articles:
Luck J, et al. Paintball-related traumatic liver injury. BMJ Case Rep 2016. doi:10.1136/bcr-2015-213780 [abstract]
Rogers C, et al. ‘Black Henna Tattoo’: art or allergen? BMJ Case Rep 2016. doi:10.1136/bcr-2015-212232 [abstract]
Winkes MB, et al.Motorcycle racer with unilateral forearm flexor and extensor chronic exertional compartment syndrome. BMJ Case Rep 2016. doi:10.1136/bcr-2016-214739 [abstract]
Scheurer J, et al. The tell-tale thigh. BMJ Case Rep 2016. doi:10.1136/bcr-2015-212909 [abstract]
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