Severe refractory hypoxemia following a gunshot injury.
We describe the case of a 57-year-old man with severe refractory hypoxemia, despite receiving ventilation therapy with 100% oxygen, following a gunshot wound to his left chest. A limited CT scan of the chest with contrast raised the suspicion of an arteriovenous (AV) fistula. Contrast-enhanced transthoracic echocardiography confirmed the presence of a pulmonary AV fistula. Traumatic pulmonary AV fistula is a rare, but serious and life-threatening condition that should be suspected in patients with thoracic injuries with persistent unexplained hypoxemia. Contrast echocardiography is a relatively simple, inexpensive, and readily available bedside test that can be used to confirm this diagnosis.
Dairywala
Ismail T
IT
Division of Cardiology, Drexel University College of Medicine, Philadelphia, PA 19012-1192, USA.
Lokhandwala
Juzar
J
Patrick
Herbert
H
Talucci
Raymond
R
Jain
Diwakar
D
D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D014463:Ultrasonography; D014948:Wounds, Gunshot / Q000150:complications*