Abstract
C l i n M e d International Library Citation: Hobbs RD, Marks JA, Kucharczuk JC, Reilly PM (2015) Gun Shot Wound to Left Chest with “Transmediastinal” Trajectory. A Case Report and Review. Trauma Cases Rev 1:009 Received: August 11, 2015: Accepted: September 16, 2015: Published: September 18, 2015 Copyright: © 2015 Hobbs RD. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hobbs et al. Trauma Cases Rev 2015, 1:1 ISSN: 2469-5777
Highlights
A 21-year old African American male presented with a single gunshot wound to the left posterior chest inferior and medial to the scapular spine
Received: August 11, 2015: Accepted: September 16, 2015: Published: September 18, 2015. This is a rare case of a gunshot wound to the posterior chest with concern for a transmediastinal trajectory that ricocheted into the cervical trachea resulting in bullet aspiration into the right bronchus intermedus
This is the first published case of a thoracic gunshot wound resulting in an isolated cervical tracheal injury
Summary
A 21-year old African American male presented with a single gunshot wound to the left posterior chest inferior and medial to the scapular spine. A portable chest radiograph demonstrated a bullet overlying the right inferior hilum (Figure 1). The bullet was located in the right inferior pulmonary hilum, but there was no obvious trajectory landing the bullet in the contralateral hemithorax. A bullet was seen lodged in the right bronchus intermedius concerning for bullet aspiration from a left sided pulmonary wound or proximal airway injury (Figure 3). A hole was identified on the left anterolateral wall of the cervical trachea at the thoracic outlet (Figure 4). The bullet was retrieved with endoscopic forceps and bronchoscope withdrawal This necessitated controlled extubation and reintubation, as the bullet diameter was larger than the endotracheal tube. The left neck was explored via incision along the anterior border of the sternocleidomastoid (Figure 5). The patient recovered well and was discharged post-injury day five without event
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