Brachiocephalic artery pseudoaneurysm following right chest gunshot injury

Case contributed by Stefan Tigges

Presentation

Status post right chest gun shot wound.

Patient Data

Age: 20 years
Gender: Male

The endotracheal tube and right chest tube are appropriately positioned, NG tube proximal side port is just above the gastroesophageal junction. Right lung consolidation is likely a contusion. Small right pleural effusion. Right paratracheal soft tissue likely represents mediastinal hematoma.

Irregular contour distal brachiocephalic and proximal right subclavian artery indicating pseudoaneurysm following gunshot injury. A flap extends into the proximal right subclavian artery. Other findings gunshot injury including right lung contusion, mediastinal hematoma, subcutaneous emphysema and T3/T4 fractures.

Lobulated brachiocephalic artery pseudoaneurysm.

Case Discussion

Gunshot injuries may result in a variety of vascular injuries including transection, extravasation of blood/contrast, arteriovenous fistula and pseudoaneurysm formation.

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