Gunshot Injury - Rare Presentation
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Gunshot injury Gunshot injury A rare presentationA rare presentation
Dr Sanjoy SanyalDr Sanjoy Sanyal
Consultant Surgeon, Consultant Surgeon,
Victoria Hospital, Ministry of Health, SeychellesVictoria Hospital, Ministry of Health, Seychelles
20042004
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Table of contentsTable of contents
Case presentationCase presentation
TreatmentTreatment
Further managementFurther management
Image findingsImage findings
DiscussionDiscussion
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Case presentation - historyCase presentation - history
32-year old male32-year old male
Security inspector in private companySecurity inspector in private company
Blast from a gunBlast from a gun
C/o bleeding from (R) earC/o bleeding from (R) ear
C/o bleeding from mouthC/o bleeding from mouth
C/o headacheC/o headache
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Case presentation - Case presentation - examinationexamination
Vitals stableVitals stable
GCS = 15/15GCS = 15/15
LMN Facial nerve palsy (R) sideLMN Facial nerve palsy (R) side
Otoscopic examinationOtoscopic examination AC filled with bloodAC filled with blood Dribbling out of EAMDribbling out of EAM TM not visualisedTM not visualised
Intra-oral examinationIntra-oral examination Hole in soft palate, oozing bloodHole in soft palate, oozing blood
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Postulated mechanism of injuryPostulated mechanism of injury
BarotraumaBarotrauma
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Case presentation - investigationsCase presentation - investigations
X-ray skullX-ray skull
X-ray cervical spineX-ray cervical spine
CT scan skullCT scan skull
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TreatmentTreatment
AntibioticsAntibiotics
Analgesics / anti-Analgesics / anti-inflammatoryinflammatory
SteroidsSteroids
Eye careEye care
Mouth careMouth care
ThiamineThiamine
Supportive measuresSupportive measures
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Further managementFurther management
Maxillo-facialMaxillo-facial
PhysiotherapyPhysiotherapy
Psychiatric evaluationPsychiatric evaluation
SurgerySurgery
Follow upFollow up
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Image findingsImage findings
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Image findingsImage findings
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Image findingsImage findings
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Image findingsImage findings
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Image findingsImage findings
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Image findingsImage findings
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Image findingsImage findings
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DiscussionDiscussion
Possible mode of injuryPossible mode of injury
Pathological anatomyPathological anatomy Para-pharyngeal spacePara-pharyngeal space
PrognosisPrognosis Facial nerveFacial nerve TinnitusTinnitus OtherOther
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Uniqueness of caseUniqueness of case
It was NOT like this
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Thank youThank you