PMC7338989_01
Entry site of bullet (black-outlined arrow).
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A 37-year-old male with no significant medical history presented to a level 1 trauma center as a level 1 trauma activation after suffering a single GSW to the right anterior chest just lateral to the midclavicular line at approximately the level of the fourth thoracic vertebra (Fig. 1).
Preoperative radiographic studies attempting to localize bullet. 2a. Chest x-ray showing hyperdensity (bullet) sitting to left of midline. 2b. Axial CT with bullet anterior to intra-ventricular septum. 2c. Axial CT with bullet track through anterior chest wall, and lung parenchymal contusion in region of the SVC. 2d. 3D reconstruction of bullet between inferior border of heart and diaphragm.
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The bullet was noted to be anterior to the apex of the heart in the pericardial fat (Fig. 2).