title: Multiple thoracoabdominal gunshot wounds with complicated trajectories.
abstract: A 41-year-old man was shot three times with a custom-made handgun. There were six small round wounds on the surface from two bullets that went into the body and one bullet found in a wall behind the victim at the scene. The gunshot wound in the left supraclavicular region bled massively. He was transferred to our hospital and soon fell into shock. A chest radiogram showed right hemothorax. Resuscitation and blood transfusion were started, and right thoracic drainage was immediately undertaken. The left subclavicular region was incised, and bleeding from the left subclavian vein stopped. Right thoracotomy was done, and bleeding from the lung was controlled. Laparotomy was needed to look for the missing trajectory. Speculation regarding trajectories of bullets in patients with multiple thoracoabdominal gunshot wounds is difficult, and an emergent operation is often needed to control bleeding or to evaluate possible organ injury.
authors.affiliation: Department of Thoracic Surgery, Osaka City University Hospital, 1-4-3 Abeno-ku, Asahi-machi, Osaka 545-8585, Japan. taiwata@med.osaka-cu.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwata
authors.forename: Kiyotoshi
authors.initials: K
authors.lastname: Inoue
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hige
authors.forename: Keiichi
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kawata
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Suehiro
mesh_terms: D000007:Abdominal Injuries / Q000473:pathology* / Q000601:surgery; D000328:Adult; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000473:pathology* / Q000601:surgery; D013898:Thoracic Injuries / Q000473:pathology* / Q000601:surgery; D014948:Wounds, Gunshot / Q000473:pathology* / Q000601:surgery