Thoracic gunshot injury withminimal pericardium disruption: a case report

Abstract

Introduction: Thoracic gunshot injury was associated with various presentation and fatality portrait. In this case report, authors will presented a case of thoracic gunshot injury with minimal pericardium disruption.

Case Report: A 26-year old Indonesian male was admitted to Sanglah General Hospital with a single gunshot wound at the left anterior chest as high as the 6^th intercostal space without any exit wound. Given the stable hemodynamic, the chest computed tomographic scan was done and confirmed that the bullet was located at the inferior border of the left ventricle with minimal hemopericardium. An explorative sternotomy was done with fluoroscopy guidance. The bullet, overlying the inferior border of the pericardium, was removed successfully. Then, the pericardium was repaired. The patient was extubated and monitored at the surgical ward. There was no eventful complication after the surgery.

Discussion The extend of gunshot wound injury to the chest depends on various factors such as the material of the bullet, mechanism of injury, velocity, and the associated structures that the bullet passed through. Emergency thoracotomy must be done in unstable patient, but for the stable patient, further radiology confirmation should be carried out for better way of exploration.

Conclusion Successful management of thoracic gunshot injury depends on identification of danger signs, proper resuscitative measures and  timely intervention.