Thoracic Gunshot Wound: A Report of 3 Cases and Review of Management View PDF

*Sandeep Kumar Kar
Department Of Cardiac Anesthesiology, Institute Of Post Graduate Medical Education & Research, Kolkata, India

*Corresponding Author:
Sandeep Kumar Kar
Department Of Cardiac Anesthesiology, Institute Of Post Graduate Medical Education & Research, Kolkata, India
Email:sndpkar@yahoo.co.in

Published on: 2015-05-23

Abstract

Thoracic gunshot injury may have variable presentation and the treatment plan differs from case to case. The risk of injury to heart, major blood vessels and the lungs should be evaluated in every patient with rapid clinical examination and basic monitoring and surgery should be considered as early as possible whenever indicated. The authors present three cases of thoracic gunshot injury with three different presentations, one with vascular injury, one with parenchymal injury and one case with fortunately no life threatening internal injury. The first case, a 52 year male patient presented with thoracic gunshot with hemothorax and the bullet trajectory passed very near to the vital structures without injuring them. The second case presented with 2 hours history of thoracic gunshot wound with severe hemodynamic instability. Surgical exploration revealed an arterial bleeding from within the left lung. The third case presented with post gunshot open pneumothorax. All three cases were managed successfully with resuscitation and thoracotomy. Preoperative on table fluoroscopy was used for localization of the bullet.

Keywords

Thoracic trauma; Gunshot injury; Traumatic pneumothorax; Emergency thoracotomy; Fluoroscopy

Introduction

Penetrating thoracic injuries have always been a nightmare to the thoracic trauma team. Patients may come with a variety of presentation and the management differs from case to case. Morbidity caused by stabbing injuries to the heart is 20%–30%, while piercing wounds cause 30%–60% of deaths.

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