HELP with a Case - X-Ray

[Horacio Massotto Chaves]

It seems to be a transmediastinal GSW in an hemodinamicaly stable patient.
What happened after the left chest tube insertion? How much blood gets out of the tube? Does the patient remais hemodinamicaly stable? Is there any sign of aerodigestive tract injury?

Horacio Massotto, MD
Costa Rica
----- Mensaje original -----
De: KMATTOX at aol.com
Fecha: Sábado, 19 de Julio de 2008, 7:49 pm
Asunto: Re: HELP with a Case - X-Ray
A: trauma-list at trauma.org
CC: SURGINET at listserv.utoronto.ca

> 
> 
> 
> Great comments and questions.   Key are the questions regarding 
> his clinical status.   His pulses in BOTH arms was STRONG and BP in 
> both arms was equal at 150/90.     He hurt in his left 
> chest, but had bilateral breath sounds according to the peripheral hospital EC 
> doctor.      
>  
> Oh Yes, he did tell me some additional information and did send me the 
> chest X-ray electronically.      
>  
> The bullet entered in the posterior Left shoulder and was palpated in the 
> RIGHT anterior chest about 2 inches below the right 
> nipple.     
>  
> When he called the ER Doctor was already putting in a left chest tube 
> because of the X-Ray Below.   Based on this NEW information, is there 
> any change to whether or not we should accept or reject the 
> patient? 
>  
> 
> 
> 
> 
> 
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