Chest Wall Foreign bodies
FIGURE 1:

Metallic Foreign Body of a curved shape. Incidental radiological finding on routine check–up, in a 27-yo male smoker’s case.

The foreign body had penetrated all muscular layers of the chest wall and was located “in direct contact with” (abutting / lying on) the parietal pleura. It was removed under a local anaesthetic and with radioscopy navigational aid.

FIGURES 2-6:

A cal. 0.38” revolver’s missile (bullet) in a 36-yo male portly ex-smoker’s case.

The patient was shot from the back and from a higher position. The entrance wound was located posteriorly, next to the spine, at the level of the 4th intespace (BLUE arrows). The posterior part of the 4th rib was fractured in numerous pieces there.

The course of the projectile: the bullet went through the full thickness of the “apical lower” segment of the pulmonary LLL (bullet’s entrance into the lung: BLUE arrows, exit: GREEN arrows). There was a fracture of the anterior-lateral part of the 5th rib, too.

The bullet was finally wedged into the subcutaneous adipose tissue along the anterior axillary line at the nipple’s level, where bruising was apparent (GREEN arrows). Pulmonary tractotomy was carried out for preserving pulmonary tissue.
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1. The extrapelural foreign body, removed

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2. The entrance wound, on the left side to the spine, posteriorly, ~4th interspace

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3. Entrance of the bullet into the lung: BLUE arrows—Exit: GREEN ones

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4. Ecchymosis or bruising, caused by the bullet, wedged under the skin

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5. The full course of the missile followed by a long pair of forceps

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6. The removed cal. 0.38" revolver's bullet