PMC5369294_01
(a) Particular appearance of skin wound including small contusion, skin introflection, and simple ecchymosis with frayed margins in the right posterior scapular area. (b and c) The preoperative appearances of the globe in emergency and operation room
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F1
On physical examination, a single bullet entry hole on the right posterior scapular area was detected [Fig. 1a]. The route of the bullet was identified by computed tomography (CT) scans obtained in several projections and signs of the damage along the path of the bullet entering from the right scapular region and leaving the body from the right orbit were confirmed [Fig. 1b and c].
Orbital computed tomography, sagittal section; along the path of the bullet, there were signs of emphysema and hematoma in the soft tissue and at the right parapharyngeal, the masticator and the inferiotemporal muscles due to penetrating injury. Furthermore, bone fracture fragments were observed along this path, especially in the lateral and the posterior wall of the maxillar sinus
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F2
Identified route was; entrance from the right posterior scapular region, passing neighboring to right lung, moving upward to the cranium by side of the carotid artery and the vein, fracturing lateral and posterior wall of the maxillar sinus, entering the orbit fracturing the orbital floor, and leaving the body through the orbit perforating the right eye [Fig. 2].