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[Left ventricular projectile migration after an accidental close-range gunshot wound]
A Driessen1,2,3, T Tjardes4, C Eikermann5
1Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Krankenhaus Köln Merheim, Kliniken der Stadt Köln gGmbH, Universität Witten/Herdecke, Witten/Herdecke, Deutschland. adriessen@ukaachen.de.
A 24-year-old female survived a severe shotgun wound to the chest and arm. The case highlights the need for comprehensive diagnostics and consideration of lead toxicity after penetrating trauma.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Radiology
Background:
- Gunshot wounds present complex challenges in emergency medicine.
- Prompt and thorough diagnostic evaluation is crucial for managing penetrating trauma.
Observation:
- A 24-year-old female sustained a shotgun wound to the left upper extremity and chest.
- Imaging revealed extensive pellet scattering in soft tissues, the chest, and lung, with cardiac involvement.
Findings:
- One shotgun pellet migrated into the left ventricle of the heart.
- The injury pattern necessitated interdisciplinary management and advanced imaging.
Implications:
- Contrast-enhanced computed tomography (CT) is recommended for comprehensive assessment of gunshot wound injuries.
- Potential lead toxicity from retained pellets requires careful consideration in patient management.
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