Gunshot Injury - Rare Presentation

Gunshot injury A rare presentation
Dr Sanjoy Sanyal
Consultant Surgeon,
Victoria Hospital, Ministry of Health, Seychelles
2004

Table of contents
Case presentation
Treatment
Further management
Image findings
Discussion

Case presentation - history
32-year old male
Security inspector in private company
Blast from a gun
C/o bleeding from (R) ear
C/o bleeding from mouth
C/o headache

Case presentation - examination
Vitals stable
GCS = 15/15
LMN Facial nerve palsy (R) side
Otoscopic examination
AC filled with blood
Dribbling out of EAM
TM not visualised
Intra-oral examination
Hole in soft palate, oozing blood

Postulated mechanism of injury
Barotrauma

Case presentation - investigations
X-ray skull
X-ray cervical spine
CT scan skull

Treatment
Antibiotics
Analgesics / anti-inflammatory
Steroids
Eye care
Mouth care
Thiamine
Supportive measures

Further management
Maxillo-facial
Physiotherapy
Psychiatric evaluation
Surgery
Follow up

Image findings

Discussion
Possible mode of injury
Pathological anatomy
Para-pharyngeal space
Prognosis
Facial nerve
Tinnitus
Other

Uniqueness of case It was NOT like this

Thank you

Gunshot Injury - Rare Presentation

by Sanjoy Sanyal

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