A team of Italian doctors has used CT to assess a man sprayed with bullets in an extraordinary hunting accident. Their case study was published on 22 December in the Lancet.
The group, led by Dr. Alberto Clerici of Azienda Ospedaliera Papardo in Messina, Italy, described a case in which a 59-year-old man presented at the hospital after having been accidentally shot by a fellow hunter.
The man underwent a whole-body CT, which showed shotgun pellets distributed throughout his body, some of which had penetrated internally to affect several organs. A chest CT showed that two of the pellets had reached the mediastinum, with one stopping only a few millimeters from the floor of the aortic arch and the other penetrating the pericardium.
A CT angiogram showed no contrast agent leakage from the aorta or pericardium, which led the team to conclude that there was no reason for the patient to undergo cardiac surgery to remove the pellets. After a few days of observation and a course of antibiotics, he was discharged.
(A) Hemorrhagic lesions evenly distributed across the torso and arms. (B) Whole-body CT scan shows the pellets. Cross-sectional CT scans show one pellet close to the floor of the aortic arch (C) and one between the pericardium and the lateral wall of the left ventricle (D). Reprinted from the Lancet, https://doi.org/10.1016/S0140-6736(18)33001-0, Clerici et al, A lucky escape during a hunting accident, Copyright (2018), with permission from Elsevier.
