Citation

Jacobs D, Hardman C, Zaman SA, Ekeh AP. Trauma Surg. Acute Care Open 2019; 4(1): e000301.

Affiliation

Department of Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA.

Copyright

(Copyright © 2019, The author(s) and the American Association for the Surgery of Trauma, Publisher BMJ Publishing Group)

DOI

10.1136/tsaco-2019-000301

PMID

31245620

PMCID

PMC6560479

Abstract

A 33-year-old woman was transferred from an outside hospital with a penetrating injury to her right chest. The patient was shot with a crossbow with the entry site to the right breast/chest and a transmediastinal trajectory. She was intubated prior to arrival due to difficulty breathing. Her vital signs remained stable and within normal limits, with good breath sounds, and no evidence of pneumothorax on chest X-ray. The tip of the bolt was palpable at the patient’s left midaxillary line. Chest X-ray in trauma bay showed the transmediastinal trajectory, and the bolt appeared to have a field point (not a broadhead point) (figure 1). A CT of the chest was obtained to assist with surgical planning. Images showed the bolt penetrating the right chest, right ventricle and inferior aspect of the left ventricular muscle, through the stomach, and ending near the tip of the spleen with a fracture of the left seventh rib ...

Language: en

Keywords

chest; diaphragmatic; penetrating cardiac or great vessel injury; penetrating trauma