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DOI: 10.1148/radiol.2312030027
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Gunshot Wounds of Abdomen: Evaluation of Stable Patients with Triple-Contrast Helical CT1

Felipe Múnera, MD, Carlos Morales, MD, Jorge A. Soto, MD2, Hector I. Garcia, MD, MS, Tatiana Suarez, MD, Vanessa Garcia, MD, Mauricio Corrales, MD and Guillermo Velez, MD

1 From the Departments of Radiology (F.M., J.A.S., T.S., V.G., G.V.), Surgery, Division of Trauma Surgery (C.M., M.C.), and Epidemiology and Biostatistics (H.I.G.), Universidad de Antioquia, Hospital Universitario San Vicente de Paúl, Medellín, Colombia. From the 2002 RSNA scientific assembly. Received January 7, 2003; revision requested March 14; final revision received August 15; accepted September 29. Address correspondence to F.M., Department of Radiology, West Wing 279, University of Miami School of Medicine, Jackson Memorial Hospital/Ryder Trauma Center, 1611 NW 12th Ave, Miami, FL 33136 (e-mail: fmunera@med.miami.edu).



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  		Figure 1. Transverse CT scan obtained in a 23-year-old man with gunshot wound to right thoracoabdominal area shows injury to diaphragm, contusion (long straight arrow) of middle lobe, and laceration (arrowheads) of right dome of liver. Laceration appears as a wide low-attenuation defect that interrupts continuity of liver parenchyma. Associated right pleural effusion (short straight arrow) and thoracostomy tube (curved arrow) are seen.

 


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  		Figure 2. Transverse CT scan obtained in 20-year-old man with gunshot wound to left lower quadrant shows perforation of sigmoid colon and extraluminal contrast material (arrowheads) anterior to sigmoid colon. Note also large bullet fragment (arrow). Patient underwent exploratory surgery, and the injury was confirmed at laparotomy.

 


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  		Figure 3. Transverse CT scan obtained in 21-year-old man with tangential gunshot wound to left flank clearly depicts extraperitoneal trajectory (long arrow) of bullet. Note laceration of abdominal wall that indicates location of exit wound (short arrow).

 


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  		Figure 4. Transverse CT scan obtained in 31-year-old man with tangential gunshot wound to right flank shows hematoma and fluid (straight arrow) located in fat adjacent to cecum. There is no associated extraluminal contrast material. Bullet (curved arrow) is located in posterior aspect of right psoas major muscle. Contrast material-filled appendix (arrowhead) is partially visualized. In this patient, a contusion of the cecal wall was found at exploratory laparotomy.

 




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