Imaging Ballistic Injuries

Here in Canada, we often think of gun violence as confined to conflict zones, terrorism, and more of a problem for our southern neighbor. However, in recent years, it has also become a Canadian problem with increased gun violence related to criminal activity presenting in daily practice. Radiologists play a critical role in the evaluation of ballistic trauma and must therefore be familiar with both the common and uncommon patterns of ballistic injury. In this article, we review the mechanisms of ballistic trauma as well as their resultant injury patterns in order to guide image interpretation.

Life-Saving Silicone Breast Implant After Firearm Injury: Case Report and Treatment Recommendations

Breast augmentation with silicone implants is one of the most commonly performed operations by plastic surgeons. Here, we report a case of a 30-year-old female patient with a ballistic injury to bilateral breast implants, where the silicone implant was likely responsible for deflecting the bullets trajectory and saving the women’s life. Ballistics analysis of bullet trajectory was performed with high-resolution computed tomography scan analysis. Operative management was implant removal, pocket irrigation, and a short course of antibiotics. A literature review was performed on all previously published breast implant–related firearm injuries. The authors advise operative management with implant removal and delay of replantation for minimum 6 months’ time.