A reserve platoon commander and Captain (Res.) Malachi Moundani were recently seriously wounded in combat in Southern Lebanon. Having suffered multiple penetrating injuries, Moundani was rushed to Rambam Health Care Campus (Rambam) in critical condition.
L) Captain (Res.) Malachi Moundani (courtesy of the family). R) Shrapnel lodged near the Captain Moundani’s aorta (courtesy of Rambam HCC).
After the Rambam medical team stabilized Moundani, 26, from moshav Neve in the Gaza envelope, image testing revealed that shrapnel had penetrated his body, positioned only a few millimeters from the aorta.
Because of the shrapnel's extremely challenging location, the physicians faced a difficult decision. On the one hand, the patient had multiple injuries, and surgery could further complicate his condition. On the other hand, the shrapnel could shift position and fatally puncture the aorta.
Following extensive consultations, Rambam's multidisciplinary medical team carried out the complex procedure, one rarely presented in the medical literature. Dr. Tzvi Adler, Attending Physician, Department of Cardiac Surgery, and department resident Dr. Kamal Morshed, successfully removed the shrapnel, saving the patient's life.
"The shrapnel was resting against the aorta, in direct contact with it," explains Professor Gil Bolotin, Director, Department of Cardiac Surgery. "The slightest movement could have perforated the artery and led to a tragic outcome. Because this is such a rare situation, we carefully evaluated whether to leave the shrapnel in place or take the surgical risk to remove it. We chose to operate. The surgery went smoothly, the patient's condition stabilized, and he was transferred to the department for further treatment and recovery."
