title: Severe refractory hypoxemia following a gunshot injury.
abstract: 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.
authors.affiliation: Division of Cardiology, Drexel University College of Medicine, Philadelphia, PA 19012-1192, USA.
authors.forename: Ismail T
authors.initials: IT
authors.lastname: Dairywala
authors.forename: Juzar
authors.initials: J
authors.lastname: Lokhandwala
authors.forename: Herbert
authors.initials: H
authors.lastname: Patrick
authors.forename: Raymond
authors.initials: R
authors.lastname: Talucci
authors.forename: Diwakar
authors.initials: D
authors.lastname: Jain
mesh_terms: 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*