Gunshot injury: bullet in spinal canal

Discussion:

Gunshot injury to the right chest wall.  Final positioning of the bullet is within the thoracic vertebral canal, with minimal vertebral bony injury.  The likely trajectory is through the right neural exit foramen.

Imaging findings include:

  • right lateral rib fracture denoting the entry site
  • lung parenchymal hematoma indicating the approximate bullet path
  • hemopneumothorax with some bullet fragments floating, and others layering dependently within the pleural fluid 
  • gas and metallic fragments present in the spinal canal superior to bullet
  • bullet deformation
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