Severe refractory hypoxemia following a gunshot injury |
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Authors: | Dairywala Ismail T Lokhandwala Juzar Patrick Herbert Talucci Raymond Jain Diwakar |
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Affiliation: | Division of Cardiology, Drexel University College of Medicine, Philadelphia, PA 19012-1192, USA. |
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Abstract: | We describe the case of a 57-year-old man with severe refractory hypoxemia, despite receiving ventilation therapy with 100% oxygen, following a gunshot wound to his left chest. A limited CT scan of the chest with contrast raised the suspicion of an arteriovenous (AV) fistula. Contrast-enhanced transthoracic echocardiography confirmed the presence of a pulmonary AV fistula. Traumatic pulmonary AV fistula is a rare, but serious and life-threatening condition that should be suspected in patients with thoracic injuries with persistent unexplained hypoxemia. Contrast echocardiography is a relatively simple, inexpensive, and readily available bedside test that can be used to confirm this diagnosis. |
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