Intramyocardial shotgun pellets diagnosed on initial emergency room chest X-ray: case report.
The diagnosis of retained intracardiac missile is usually made at thoracotomy or fluoroscopy. Close inspection of plain chest X-rays may reveal blurring of radiopaque objects that are moving with the beating heart. In a gunshot wound victim who is initially stable, observation of this phenomenon should prompt a very high index of suspicion for cardiac injury. Invasive hemodynamic monitoring is indicated, and thoracotomy should be performed if penetrating cardiac injury is confirmed.
Skipper
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Department of Surgery, Akron City Hospital, OH 44309.
Debski
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D000328:Adult; D004630:Emergencies; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006335:Heart Injuries / Q000000981:diagnostic imaging*; D006801:Humans; D013902:Radiography, Thoracic; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging*