Intracardiac foreign body resulting from a transmediastinal gunshot mimics an extracardiac foreign body: An image presentation
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
Journal Volume
116
Journal Issue
10
Pages
815
Date Issued
2017-10
Author(s)
Abstract
A transmediastinal gunshot wound (TMGW) is one of the most severe traumatic injuries, with a high mortality rate. Prompt diagnosis and emergency surgical intervention with or without cardiopulmonary bypass are usually required to save lives. We report a particular case of TMGW in which the computed tomography imaging findings indicated an extracardiac foreign body. However, intraoperative findings revealed an intracardiac foreign body, and urgent cardiopulmonary bypass was performed to remove the foreign body. We suggest that cardiopulmonary bypass should be on standby during an exploratory sternotomy for TMGW, when the trajectory of the bullet hints at a cardiac-penetrating injury according to imaging studies and the location of the bullet remains unaffected by the patient's postural changes.
Subjects
Surgery; Transmediastinal gunshot wound (TMGW)
SDGs
Other Subjects
adult; Article; blood clot; body position; bullet; cardiopulmonary bypass; case report; clinical article; computer assisted tomography; ecchymosis; echocardiography; emergency ward; foreign body; gunshot injury; heart left atrium; heart left ventricle ejection fraction; heart right ventricle; heart ventricle septum defect; human; interatrial septum; intraoperative period; male; pericardial effusion; physical examination; sitting; sternotomy; tachycardia; thorax pain; thorax radiography; thorax wall; transmediastinal gunshot wound; tricuspid valve regurgitation; diagnostic imaging; foreign body; gunshot injury; injuries; mediastinum; x-ray computed tomography; Adult; Cardiopulmonary Bypass; Foreign Bodies; Humans; Male; Mediastinum; Sternotomy; Tomography, X-Ray Computed; Wounds, Gunshot
Publisher
ELSEVIER TAIWAN
Type
journal article