title: Total mediastinal traverse with isolated internal mammary artery transection.
abstract: Transmediastinal gunshot wounds are infrequent but life-threatening injuries. The course of the projectile and the bullet track often is unpredictable. Prompt and specific diagnostic and therapeutic interventions are necessary to quickly identify and repair potentially life-threatening injuries to the heart, great vessels, and the aerodigestive tract. Multiple diagnostic algorithms exist for work-up of these injuries, and the therapeutic interventions are diverse and challenging. We describe a patient with total mediastinal traverse, who presented with right-sided hemopneumothorax. The work-up revealed surprisingly an isolated left internal mammary artery transection with a significant hemorrhage that mandated surgical intervention in left chest.
authors.affiliation: Department of Surgery, North Shore University-Long Island Jewish Medical Center, The Long Island Campus of the Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA. akhoy@lycos.com
authors.forename: Ali
authors.initials: A
authors.lastname: Khoynezhad
authors.forename: Leonard
authors.initials: L
authors.lastname: Barrett
authors.forename: Ernesto
authors.initials: E
authors.lastname: Hayn
authors.forename: Gerald W
authors.initials: GW
authors.lastname: Shaftan
mesh_terms: D000328:Adult; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006468:Hemopneumothorax / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013907:Thoracostomy; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery