CXR Case 136

Gun shot wound to the right lateral abdomen. No exit wound noted.

RR 18; P – 110; BP 102/55; GCS 15

CXR CASE 136 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

Lung fields are clear. No pneumothorax or effusions.

  • The is a 7.62 bullet projected inferior to the medial right hemidiaphragm.
  • A lateral X-ray or CT is needed to localize the position more accurately.

CLINICAL CORRELATION

FAST scan revealed free fluid in the abdomen and the patient went to theatre for a laparotomy.

He had haemorrhage from a liver laceration and small bowel perforation. The diaphragm was intact.


CLINICAL PEARLS

With a single AP projection such as this, it is very difficult to determine if the bullet is in the soft tissues around the spine, posterior thoracic cavity, or abdomen.


TOP 150 CXR SERIES



Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar |

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