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
Table of contentsTable of contents
Case presentationCase presentation
TreatmentTreatment
Further managementFurther management
Image findingsImage findings
DiscussionDiscussion
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
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
Postulated mechanism of injuryPostulated mechanism of injury
BarotraumaBarotrauma
Case presentation - investigationsCase presentation - investigations
X-ray skullX-ray skull
X-ray cervical spineX-ray cervical spine
CT scan skullCT scan skull
TreatmentTreatment
AntibioticsAntibiotics
Analgesics / anti-Analgesics / anti-inflammatoryinflammatory
SteroidsSteroids
Eye careEye care
Mouth careMouth care
ThiamineThiamine
Supportive measuresSupportive measures
Further managementFurther management
Maxillo-facialMaxillo-facial
PhysiotherapyPhysiotherapy
Psychiatric evaluationPsychiatric evaluation
SurgerySurgery
Follow upFollow up
Image findingsImage findings
Image findingsImage findings
Image findingsImage findings
Image findingsImage findings
Image findingsImage findings
Image findingsImage findings
Image findingsImage findings
DiscussionDiscussion
Possible mode of injuryPossible mode of injury
Pathological anatomyPathological anatomy Para-pharyngeal spacePara-pharyngeal space
PrognosisPrognosis Facial nerveFacial nerve TinnitusTinnitus OtherOther
Uniqueness of caseUniqueness of case
It was NOT like this
Thank youThank you