Presentation
Gunshot wound right chest.
Patient Data
Presenting Chest X-ray
Right thoracostomy tube appropriately positioned, paper clips mark gunshot entrance/exit wounds. Consolidation right lung represents pulmonary contusion/laceration. Small right hemothorax, no pneumothorax.
Right pulmonary bullet track with lobulated right pulmonary artery pseudoaneurysm. Right chest tube, small right hemo/pneumothorax. Right pulmonary contusion and atelectasis.
Chest X-ray 2 days later
Worsening opacity right lung, likely worsening contusion/hemorrhage.
Angiogram 2 days after GSW
Large bilobed right pulmonary artery pseudoaneurysm.
Chest X-ray after embolization
Multiple embolism coils right pulmonary artery, resolving right pulmonary laceration/contusion.
Case Discussion
Gunshot wounds to the lung most frequently result in pulmonary contusions and lacerations, but vascular injuries such as vessel tears, vessel occlusion, arteriovenous fistula formation, and, as in this case, pseudoaneurysm formation may occur. This pseudoaneurysm was successfully embolized.