PMC7575832_01
Chest radiograph taken in the trauma bay without evidence of pneumothorax, hemothorax, or retained bullet fragment.
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Chest x-ray was negative for pneumothorax, most likely due to the needle decompression performed in the field, and negative for retained bullet fragments (Fig. 1).
CT scan abdomen/pelvis with IV contrast - axial view demonstrates grade IV splenic injury with splenic hematoma and contrast extravasation indicating active bleeding due to splenic rupture (blue arrow).
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CT scanner allowed for better visualization and evaluation of the extent of injuries the patient suffered from the gunshot wound and significantly aided in addressing those injuries intraoperatively. CT of the chest, abdomen and pelvis with IV contrast were performed which revealed a left sixth rib fracture, a left pulmonary contusion, a left hemothorax, a grade 4 splenic injury with contrast extravasation (Figs. 2 & 4), left kidney injury with contrast extravasation and a perinephric hematoma measuring 13 cm x 8 cm x 6 cm (Figs. 3 & 4), and foci of pneumoperitoneum in the left side of the abdomen.
CT scan abdomen/pelvis with IV contrast - coronal view demonstrates a large left sided perinephric hematoma (blue arrow). Part of the spleen is also seen highlighted with IV contrast (yellow arrow) and splenic hematoma (red arrow) due to splenic rupture.
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CT scanner allowed for better visualization and evaluation of the extent of injuries the patient suffered from the gunshot wound and significantly aided in addressing those injuries intraoperatively. CT of the chest, abdomen and pelvis with IV contrast were performed which revealed a left sixth rib fracture, a left pulmonary contusion, a left hemothorax, a grade 4 splenic injury with contrast extravasation (Figs. 2 & 4), left kidney injury with contrast extravasation and a perinephric hematoma measuring 13 cm x 8 cm x 6 cm (Figs. 3 & 4), and foci of pneumoperitoneum in the left side of the abdomen.