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 bulled in the spinal canal and its trajectory fracturing a rib on the right and causing a lung haemorragic lesion with pneumothorax and pleural effusion. 

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: 2nd Sep 2015
Tags: trauma, spine
Inclusion in quiz mode: Included

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