Minimum cause--maximum effect: the travelogue of a bullet.
This case report involves a 57-year-old male, accidentally shot in the chest with a small bore firearm. The bullet entered the left hemithorax, disrupting the left internal mammarian artery. It then penetrated the anterior wall of the right ventricle causing a pericardial tamponade. After leaving the base of the right heart it perforated the diaphragm, the liver, the spleen and the pancreas. Finally, it penetrated the abdominal aorta 3 cm proximally to the coeliac trunk and reached its final position paravertebrally. This case report illustrates that the management of even minimum gunshot wounds requires a maximum variety of surgical skills.
Hartert
Marc
M
Department of Cardiothoracic and Vascular Surgery, University Medical Center, Johannes Gutenberg University, Langenbeckstrasse 1, 55131 Mainz, Germany. marc.hartert@unimedizin-mainz.de
Dahm
Manfred
M
Neufang
Achim
A
Vahl
Christian-Friedrich
CF
D000059:Accidents; D001011:Aorta / Q000293:injuries; D006348:Cardiac Surgical Procedures; D002305:Cardiac Tamponade / Q000209:etiology; D003964:Diaphragm / Q000293:injuries; D013505:Digestive System Surgical Procedures; D044709:Forensic Ballistics; D006335:Heart Injuries / Q000209:etiology; D006352:Heart Ventricles / Q000293:injuries; D006439:Hemodynamics; D006801:Humans; D008099:Liver / Q000293:injuries; D008297:Male; D008323:Mammary Arteries / Q000293:injuries; D008875:Middle Aged; D009104:Multiple Trauma / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D010179:Pancreas / Q000293:injuries; D013154:Spleen / Q000293:injuries; D013898:Thoracic Injuries / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014948:Wounds, Gunshot / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery