Spinal cord contusion and paraplegia resulting from indirect gunshot injury [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-12686 | DOI: 10.14744/tjtes.2020.12686  

Spinal cord contusion and paraplegia resulting from indirect gunshot injury

Chen-Wei Wu1, Chien-Chin Hsu2, Kuo-tai Chen3
1Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
2Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan
3Department of Biotechnology, Southern Tainan University of Technology, Tainan, Taiwan

Introduction
Emergency physicians may overlook spinal cord injury in patients when the direct impact of a gunshot on the spine is lacking.
Case presentation
A 30-year-old man who was shot on his right chest wall was brought to the emergency department. He arrived in a state of shock and underwent emergent thoracotomy for massive hemothorax. After surgery, he was found to be paraplegic. Magnetic resonance imaging of the spine showed T4 spinal cord contusion.
Discussion
The penetrating bullet dissipates energy to the surrounding tissue and contuses the spinal cord. Another assumption of the spinal cord injury is the impairment of blood supply to the cord. No effective treatment exists for gunshot-related indirect injury to the spinal cord.
Conclusion
These reported cases reminded emergency physicians that after stabilization of the patient with a gunshot wound, a complete neurologic examination should be performed to discover occult spinal cord injury.

Keywords: spinal cord injury, paraplegia, gunshot, indirect injury




Corresponding Author: Kuo-tai Chen, Taiwan


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