PMC2633272_01
Left neck entry wound.
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F1
Examination revealed an entry wound 1 cm below the level of the thyroid notch to the left of the midline, figure 1.
Cervical spine radiograph showing pellet and haematoma.
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F2
Cervical spine radiographs demonstrated an airgun pellet antero-lateral to the transverse process of C6, with a surrounding 6 cm diameter radiopacity consistent with haematoma and no deviation of the trachea, figure 2.
Intra-operative image intensification views showing air gun pellet anterior to transverse process of C6 vertebra.
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F3
The airgun pellet was localised using image intensification and successfully retrieved from the paraspinous muscles, figure 3.
Airgun pellet deep to external carotid artery.
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F4
The pellet tract traversed the left lobe of the thyroid gland and the carotid sheath, impacting on the antero-medial aspect of the external carotid artery, just above the bifurcation, figure 4.