Thoracic gun shot wound

Case contributed by Stefan Tigges
Diagnosis certain

Presentation

The patient presents after being shot in the left chest.

Patient Data

Age: 30 years
Gender: Male
x-ray

Bullet fragments project over the left chest. Consolidation left lung likely represents pulmonary contusion, small left pleural effusion likely represents hemothorax. No pneumothorax.

ct

A chest tube has been placed and is appropriately positioned. Left parasternal soft tissue defect with bullet track extending laterally and inferiorly resulting in left upper lobe laceration and contusion with contusion left lower lobe as well. Bullet fragments left lung with the largest fragment adjacent to a later left eighth rib fracture. No active contrast extravasation, pseudoaneurysm or traumatic arteriovenous fistula. Small left hemopneumothorax with passive atelectasis left lower lobe.

Case Discussion

Typical gunshot wound findings left chest resulting in hemopneumothorax, pulmonary laceration (the defect or "cut" in the left lung) and contusion (the white hemorrhage or "bruise" in the left lung). No findings of vascular injury.

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