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| A PICTURE IS WORTH A THOUSAND WORDS |
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| Year : 2010 | Volume
: 11
| Issue : 3 | Page : 126-127 |
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Fortunate finger deviation of a fatal heart bullet injury
Duilio Divisi, Carmine Villani, Sergio Di Tommaso, Alessandro Mazzola
Department of Cardiothoracic Surgery, "G. Mazzini" Hospital, Teramo, Italy
| Date of Web Publication | 22-Feb-2011 |
Correspondence Address:
Duilio Divisi
Circonvallazione Ragusa 39, 64100 Teramo
Italy
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1995-705X.76810
How to cite this article:
Divisi D, Villani C, Tommaso SD, Mazzola A. Fortunate finger deviation of a fatal heart bullet injury. Heart Views 2010;11:126-7 |
A young man arrived at the emergency room complaining of two lesions: one in the middle left finger and the other in the left nipple line. He was hemodynamically stable, conscious and able to say that he had been shot at a distance of 3 m, protecting himself with his left hand. Based on computerized tomography (CT) of the thorax [Figure 1], we preferred median sternotomy approach instead of videothoracoscopy. [1],[2] We discovered a left ventricular injury without rupture of cardiac cavity; the bullet was found in the pericardium. The heart bullet injury was repaired with interrupted monofilament stitches reinforced by Teflon strips [Figure 2]. [3] | Figure 1: a) The bullet's left nipple line wound; b) chest X-ray shows the intracardiac bullet; c) CT of the thorax reveals bilateral hemothorax and a huge fluid collection in the pericardium. The ribs were undamaged. The trajectory of the bullet was deviated by the finger seems to be from the left to the right side of chest
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 | Figure 2: Intraoperative view. a) The entry and exit heart wounds; b) the reinforcement of suture by Teflon strips; c) bullet
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 References | |  |
| 1. | Divisi D, Battaglia C, De Berardis B, Vaccarili M, Di Francescantonio W, Salvemini S, et al. Video-assisted thoracoscopy in thoracic injury: Early or delayed indication? Acta Biomed 2004;75:158-63. 
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| 2. | Casós SR, Richardson JD. Role of thoracoscopy in acute management of chest injury. Curr Opin Crit Care 2006;12:584-9.
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| 3. | Doetsch N, Wolfhard U, Mathers MJ, Zerkowski HR. Survival after heart and coronary-artery penetration by an air-rifle projectile. Thorac Cardiovasc Surg 1989;37:332-4.
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[Figure 1], [Figure 2]
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