Tanmoy Ganguly, Sandeep Kumar Kar, Chaitali Sen, Chiranjib Bhattacharya, Manasij Mitra
Thoracic gunshot injury may have variable presentation and the treatment plan differs. The risk of injury to heart, major blood vessels and the lungs should be evaluated in every patient with rapid clinical examination and basic monitoring and surgery should be considered as early as possible whenever indicated. The authors present three cases of thoracic gunshot injury with three different presentations, one with vascular injury, one with parenchymal injury and one case with fortunately no life threatening internal injury. The first case, a 52 year male patient presented with thoracic gunshot with hemothorax and the bullet trajectory passed very near to the vital structures without injuring them. The second case presented with 2 hours history of thoracic gunshot wound with severe hemodynamic instability. Surgical exploration revealed an arterial bleeding from within the left lung. The third case presented with post gunshot open pneumothorax. All three cases managed successfully with resuscitation and thoracotomy. Preoperative on table fluoroscopy was used for localisation of bullet.
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