INTRATHORACIC GUNSHOOT WOUND

Ardiansyah B 1, Sarwono P 2
Resident of Radiology1,Staff of Radiology2 Department Dr. Moewardi Hospital,
Sebelas Maret University, Surakarta

Introduction
Thoracic injuries are a contributing factor in as many as 75% of all trauma-related deaths. Determining the
firing distance is of great importance from the point of view of a criminal investigation. Multi-sliced Computed
Tomography (MSCT) data could provide valuable information in the forensic assessment.

Case Report
A 29 years old man with intrathoracic gunshoot wound was referred to Moewardi Hospital. Right
hematothorax was found during Water Sealed Drainage (WSD) procedure was done at previous hospital.
Chest X- Ray showed right pulmonal contusion, right pleural effusio and metal density of opacity projected
as high as 8th right posterior costae, 3.5 cm from processus spinosus and 1.5 cm from the marker. Contrasted
chest MSCT demonstrated metal corpus alienum projected as the level of 8th right SIC penetrating
subcutaneously, pleural cavity and right lung parenchyma leading to right hematothorax, collapse of
medial lobe right lung and 8th right posterior costae fracture.
Discussion
In our case chest x-ray and contrasted chest MSCT demonstrate closed distant gunshoot wound as the bullet
port d’entry was from the front, penetrating the right lung parenchyma, causing right hematothorax and
collapse of medial lobe right lung.
Conclusion
Radiology takes an important role especially in the forensic assessment. MSCT is rapidly evolving into a
primary diagnostic tool because of its ability to image various, intrathoracic structures and to differentiate
substances of different densities.
Key words: Gunshoot wound, hematothorax , Chest X-ray, Contrasted chest MSCT.