Presentation
Gunshot victim with entry hole in anterior thorax.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
In the scout images of the CT scan enlargement of the anterior mediastinum and foreign body (bullet) in the upper left quadrant of the abdomen are visible.
These images demonstrate aortic injury with mediastinal hematoma and left hemotorax.
No exit hole from the bullet was identified.
Additionally, note the hypoattenuation of the left renal parenchyma without signs of free fluid in the upper abdomen, suggesting renal infarction.
Unfortunately, the bullet has not been identified in this protocol.
Case Discussion
Gunshot victim with anterior thorax entry hole.
Thorax CT was performed to evaluate vascular complications.
These images demonstrate aortic injury with mediastinal hematoma and left hemotorax.
No exit hole from the bullet was identified.
Additionally, notes the hypoattenuation of the left renal parenchyma without signs of free fluid in the upper abdomen, suggesting renal infarction.
Unfortunately, the bullet has not been identified in this protocol.
In CT scanogram images, the bullet was identified in the projection of left renal artery and embolism was suspected.
This suspicion was confirmed at the emergency surgery.
Ballistic embolism is an unusual and interesting manifestation of penetrating trauma. The most common locations of systemic vascular embolisms are intracardiac, thoracic / abdominal aorta, pulmonary veins and vena cava infeiror.
Bullet embolism to renal artery complicated with renal infarction is a rare condition of extreme severity, which requires agility of the emergency department.
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