Case Report: Penetrating Thoracic Trauma by A Gunshot Involving the Heart

Firearm-related mortality is not frequently encountered in a country like Nepal where there are stringent laws prohibiting the buying, selling, carrying or storing of firearms. To possess a firearm a person must have a valid license. Wounds produced by firearms have typical characteristics the knowledge of which helps to identify the type of firearm used, range of fire, the position of the victim, and whether the manner of death was homicidal, suicidal, or accidental. The present case is the first autopsy-based study from Nepal which discusses the wounds produced by firearms with an interpretation of such findings for medicolegal purposes. The present case highlights a social problem where the victim, a psychiatric patient, had no access to prescription medication due to coronavirus disease (COVID-19) related lockdown.

Case Report: Penetrating Thoracic Trauma by A Gunshot Involving the Heart

Firearm related mortality is not frequently encountered in a country like Nepal where there us a stringent law prohibiting buying, selling, carrying or storing of firearms. It is required to have a valid license to have a firearm in possession. Wounds produced by firearm have a typical characteristic the knowledge of which helps to identify the type of firearm used, range of fire, position of the victim and whether the manner of death was homicidal, suicidal or accidental. The present case is a first autopsy-based study from Nepal which discusses the wounds produced by firearm with interpretation of such findings for medicolegal purposes. The present case highlights a social problem where the victim, a psychiatric patient, had no access to prescription medication due to coronavirus disease (COVID-19) related lockdown.

Penetrating Thoracic Trauma Arising From Knife Injuries Into the Hemithorax: A Case Report

BackgroundTrauma is associated with a high morbidity and mortality, and thoracic trauma accounts for a quarter of these deaths. This is due to the penetrating thoracic trauma that often causes serious injury to the heart and great vessels. Most penetrating thoracic wounds are caused by stabbing, which is usually caused by knives. Here, we report a patient who had penetrating thoracic trauma who was caused by a knife.Case presentationA 16-year-old girl was stabbed by a knife due to an accidental fall, which caused a penetrating injury in her left chest. Despite a decreased blood pressure (100/90 mmHg), the patient was conscious. The unenhanced CT at emergency clearly showed that the knife penetrated between the pericardium and the left lung without heart injury. Exploratory thoracotomy was performed in the fourth intercostal space in combination with thoracoscopy, confirmed that the knife penetrated between the pericardium and the left lung without causing any injury to the heart.ConclusionsCT can not only clearly display foreign bodies of knives, but also accurately judge the damage of important structures such as lungs, heart and great vessels. Therefore, CT can provide information for further diagnosis and intervention.

Thorax Gunshot and Sharp Cutting Tool Injuries: For 5 Months Nyala Experiences

Background: The two most common causes of penetrating thoracic trauma are firearm injuries and injuries by sharpened cutting tool. Penetrating thoracic injuries are risk factors for high mortality and morbidity, so they need to be diagnosed correctly and timely in order to perform an effective intervention. In this study, patients with penetrating thoracic trauma were treated through surgical intervention accompanying minimal morbidity–mortality compared to literature, even though they were admitted relatively late. Methods: In this retrospective study, 29 gunshot and stab wounds penetrating thoracic trauma patients were admitted to the emergency department of Nyala Sudan Turkey Education and Research Hospital between April and September 2018. Results: Of the 29 patients, 7 (24.13%) were gunshot injuries and 22 (75.86%) were injured with a sharp cutting tool. While 13 of the cases (44.82%) were admitted on the day the incident took place, 5 of them (17.24%) were post-traumatic first day of the admission, 9 of them (31.03%) were post-traumatic day 2, whereas 1 of them (3.44%) was post-traumatic the third day of admission. Finally, 14 patients (48.28%) were followed-up conservatively without tube thoracostomy, while 15 patients (51.72%) underwent tube thoracostomy in follow-up. No patient was operated for penetrant trauma. Mortality was not seen. Conclusion: Patients with penetrating thoracic trauma were treated by surgical interventions accompanying minimal morbidity–mortality even though they were admitted relatively late to healthcare facilities. Key words: penetrating thoracic injuries, sharp cutting tool, gunshot