Pectoral girdle shotgun injury

Case contributed by Henry Knipe
Diagnosis certain


"Minding my own business."

Patient Data

Age: 30 years
Gender: Male

Multiple metallic densities project over the left neck, shoulder and chest and are consistent with shotgun pellets. Fracture of the distal third of the right clavicle with adjacent subcutaneous emphysema. 

Right pectoral girdle gunshot injury with distal right clavicle fracture. Given the pattern of pellets there is a presumed scapular fracture but this is not well seen due to artifact and a scapular x-ray is recommended. No significant arterial injury identified.

Case Discussion

Shotgun injuries can be dramatic in appearance, and this patient is lucky not to have suffered serious neurovascular injury. A history of two gunshots was given, and this can be seen on imaging with one cluster of pellets around the scapula, and another around the distal clavicle. 

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