Gunshot injury: bullet in spinal canal

Case contributed by Dr Alexandra Stanislavsky

Presentation

Accidental injury.

Patient Data

Age: 30
Gender: Male
Modality: X-ray

Signs of lower ribs fractures on the right, drained pleural effusion on the right and bullet fragments projected over a lower thoracic vertebral body.

Modality: CT

Selected CT images showing the bullet in the spinal canal. The trajectory of the bullet had fractured a rib on the right and resulted in a pulmonary haemorrhage and haemopneumothorax. 

Case Discussion

Gun shot injury to right chest wall.  Final positioning of the bullet is within the thoracic vertebral canal, with minimal vertebral bony injury.  The likely trajectory is through the right neural exit foramen.

Imaging findings include:

  • right lateral rib fracture denoting the entry site
  • lung parenchymal haematoma indicating the approximate bullet path
  • haemopneumothorax with some bullet fragments floating, and others layering dependently within the pleural fluid 
  • gas and metallic fragments present in the spinal canal superior to bullet
  • bullet deformation
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Case Information

rID: 13204
Case created: 13th Mar 2011
Last edited: 23rd May 2017
Tags: trauma, spine
Inclusion in quiz mode: Included

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