Presentation
Gunshot with a metallic screw.
Patient Data
Metallic screw owing to a gunshot projects over the left upper quadrant.
A hyperdense metallic foreign body is seen within the mid-portion of the splenic parenchyma associated with lower pole splenic laceration measuring about 1.9 x 2.3 cm, as well as minimal perisplenic free fluid and air foci indicating pneumoperitoneum. ِAs noted on pulmonary window images, the tip of the metallic object is seen penetrating the left copula of the diaphragm, with associated left basal pleural reaction and thickening. A skin defect is noted within the mid-portion of the left lateral anterior abdominal wall associated with surgical emphysema which extends to the abdominal cavity where minimal fat stranding and a rim of free fluid are noted. The related muscle appears bulky suggesting muscle hematoma.
Postoperative x-ray follow-up with removal of the metallic foreign body.
Case Discussion
Post gunshot injury with minimal splenic laceration, diaphragmatic injury, and associated hematoma.