Thoracic gunshot wound

Case contributed by Dr Bita Abbasi

Presentation

A young man was brought to emergency department with a bullet injury to the chest.

Patient Data

Gender: Male
Modality: CT

A bullet is noted in the right lung. linear consolidation in the trajectory of the bullet and emphysema in the right chest wall are seen.

Case Discussion

In the setting of gunshot wound to the lung, the missile injury is readily visible because of the difference in the tissue characteristics of injured lung with the remaining healthy lung tissue. Because of the elastic recoil feature of the pulmonary parenchyma, the laceration area is commonly reformed to a round area of consolidation and it is unusual to see the lineal missile track on imaging. 

Pulmonary lacerations are classified into four types:

  1. Compression-rupture laceration: it is the most common type of laceration that usually occurs as a 2-8 cm lesion in the central lung.
  2. Compression shear: occurs after sudden compression of the lower chest when the lung suffers from a shear injury to the spine.
  3. Rib penetration laceration: occur with a penetrating fractured rib. These lesions are commonly multiple.
  4. Adhesion tears: occurs in sudden injuries of the chest wall where prior pleuropulmonary adhesions had been created.
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Case Information

rID: 35690
Case created: 16th Apr 2015
Last edited: 15th Feb 2016
System: Chest
Inclusion in quiz mode: Included

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