DISASTER MEDICINE No. 2 •2026

doi: 10.33266/2070-1004-2026-2

CLINICAL ASPECTS OF DISASTER MEDICINE

Original article

A Blind Shell Wound of the Thirg with Rupture of the Deep Femoral Artery, Deep Femoral Vein, and Formation of a Giant Pulsating Hematoma: Surgical Treatment in a Military Field Hospital in the Area of the Special Military Operation Zone

Kazantsev A.N. 1, Vshivkov K.N. 1, Shengelia N.G. 1, Popov A.A. 1, Gaptrakipov I.Kh. 1, Pavlenko N.A. 1, Tenishev R.R. 1, Kholmatov V.N. 1

Download the article in pdf format

1 Military Field Hospital of the 36th Separate Medical Detachment (Airmobile) of the Airborne Troops of the Ministry of Defense of the Russian Federation, Ivanovo, Russian Federation

UDC 617.581-001.45-089:616.137.83:613.67

P. 35-39

 

Summary. The objective of the study – to demonstrate a clinical example of successful surgical treatment of a soldier with a shrapnel wound to the thigh, accompanied by a rupture of the deep femoral artery and deep femoral vein, and the formation of a giant pulsating hematoma, at a military field hospital in the area of the Special Military Operation.
Research materials and methods.
Clinical example
A 39-year-old soldier. During a combat mission in the area of the Special Military Operation, he sustained a shrapnel wound to the left thigh as a result of a shell explosion. Two days later, he was evacuated to the nearest military field hospital.
Complaints on admission: pain in the left thigh. Status localis: a hematoma with blood imbibition is detected on the anterior, posterior, and inner thigh surfaces, extending to the anterior abdominal wall and genitals. A rounded, pulsating mass is palpated in the upper third of the inner thigh, causing tenderness. A 2-cm diameter wound without drainage is present on the outer surface of the middle third of the left thigh. A color Doppler ultrasound of the left lower extremity revealed a rupture of the lateral wall of the deep femoral artery (DFA) and deep femoral vein (DFV), with the formation of a pulsating hematoma with a volume of approximately 40 ml. Surgery was performed: hematoma removal, suturing of the DFA and DFV wall defects with 6/0 polypropylene suture. The postoperative period was uneventful. The patient was discharged in satisfactory condition on the 30th day after surgery and returned to military service.
Conclusion: successful removal of a pulsating hematoma with suturing of the deep femoral artery and deep femoral vein wall defects at a military field hospital prevented the development of bleeding, hematoma suppuration, and death. 

Keywords: deep femoral artery rupture, deep femoral vein rupture, formation of a giant pulsating hematoma, military field hospital, shrapnel wound of the thigh, Special Military Operation, surgical treatment

For citation: Kazantsev A.N., Vshivkov K.N., Shengelia N.G., Popov A.A., Gaptrakipov I.Kh., Pavlenko N.A., Tenishev R.R., Kholmatov V.N. A Blind Shell Wound of the Thirg with Rupture of the Deep Femoral Artery, Deep Femoral Vein, and Formation of a Giant Pulsating Hematoma: Surgical Treatment in a Military Field Hospital in the Area of the Special Military Operation. Meditsina Katastrof = Disaster Medicine. 2026;2:35-39 (In Russ.). doi:10.33266/2070-1004-2026-2-35-39

 

REFERENCES

  1. Kazantsev A.N. Surgical Treatment of Patients with False Aneurysms of Peripheral Arteries after a Shrapnel wound in a Military Field Hospital in a Combat Zone. Indian J Thorac Cardiovasc Surg. 2025;41;12:1798-1803. Doi: 10.1007/s12055-025-02080-w.
  2. Ivchenko Ye.V., Ovchinnikov D.V. The Main Scientific and Practical Results of the Study of Combat Pathology during a Special Military Operation at the Military Medical Academy. Izvestiya Rossiyskoy Voyenno-Meditsinskoy Akademii = Russian Military Medical Academy Reports. 2024;43; 4:457-469 (In Russ.). Doi: 10.17816/rmmar636549
  3. Dorokhov A.Ye., Akperova S.R., Prosvetov S.G. Analysis of the Nature of Injuries and Wounds Received during a Special Military Operation. Molodezhnyy Innovatsionnyy Vestnik = Youth Innovation Bulletin. 2023;12;2:138-140 (In Russ.).
  4. Gavrilov Ye.K., Ramazanov A.Yu., Goncharov A.V., et al. Frequency and Structure of Combat Gunshot Vascular Trauma in an Advanced Third-Level Medical Organization in a Modern Armed Conflict. Angiologiya i Sosudistaya Khirurgiya. Zhurnal im. Akademika A.V.Pokrovskogo = Journal Angiology and Vascular Surgery will be named after Academician A.V. Pokrovsky. 2024;30;2:143-150 (In Russ.). Doi: 10.33029/1027-6661-2024-30-2-143-150.
  5. Trishkin D.V., Kryukov Ye.V., Davydov D.V., et al. Improvement of External Fixation as a Basis for Innovative Staged Treatment of Limb Wounds. Meditsinskiy Vestnik GVKG im. N.N.Burdenko = Medical Bulletin of the N.N. Burdenko Main Military Clinical Hospital. 2023;12; 2:7-18 (In Russ.). Doi: 10.53652/2782-1730-2023-4-2-7-18.
  6. Kraynyukov P.Ye., Shershnev S.P., Rybchinskiy S.S. Ultrasound Diagnostics in Military Personnel during a Special Military Operation: Current Organizational and Diagnostic Aspects. Voyenno-Meditsinskiy Zhurnal = Military Medical Journal. 2024;345;10:50-57 (In Russ.). Doi: 10.52424/00269050_2024_345_10_50.
  7. Gavrilov Ye.K., Zokhrabov F.I., Khubulava G.G. Ultrasound Angioscanning in Early Diagnostics of Combat-Related Gunshot Vascular Trauma of the Lower Extremities. Flebologiya = Journal of Venous Disorders. 2023;17;4:320-328 (In Russ.). Doi: 10.17116/flebo202317041320.
  8. Vasil’yev D.S., Kazantsev A.N., Kolesnikov V.V., et al. Removal of a Metal Fragment and a Floating Thrombus from the Internal Jugular Vein of a Serviceman in a Military Field Hospital. Meditsina Ekstremal’nykh Situatsiy = Medicine of Extreme Situations. 2025;27;4:500-504 (In Russ.). Doi: 10.47183/mes.2025-349.

 

The material was received 27.11.25; the article after peer review procedure 27.03.26; the Editorial Board accepted the article for publication 16.06.26
Copyright © 2026 “Disaster Medicine” Journal | Powered by “Disaster Medicine” Journal