GSW TO RIGHT CHEST. CT of airway

[KMATTOX at aol.com]

Thx for the CT cuts.   I am still a bit confused as to what to  do.      My 
choice to go to CT first is because the CT  is close by and quicker than 
arteriogram, and my review of the mediastinum and  my assumed projection did not go 
near the vessels.   Besides, if he  had had a major vessel injury, he would 
have been different hemodynamically or  would have had more blood out the r 
chest.   
 
I cannot really establish trajectory well, but it appears to me that the  
course is near the espphagus.   I still want a barium,  (BARIUM,  not gastro 
grafin ) Study.    
 
I did not see the bronchi.    I think there is a good chance  that the airway 
injury is in the RIGHT bronchus.      
 
On this CT I see no evidence of any vascular injury, so far, but the cuts  
are selected.      
 
By what you have told us so far, In my view he still has an esophageal or  
bronchus (or tracheal injury).     
 
And I am thinking of a Right Posterolateral thoracotomy at 4th ICS, but not  
yet ready to post him, because I have not proved it yet.   
 
k



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