case_images: PMC10626754_01
case_images: Initial chest radiograph at the emergency room. Round radiopaque material which was thought to be a foreign body (marble) at the right upper lung, with fracture of the fourth posterior rib. AP, anteroposterior; LAT, lateral.
case_images: tsaco-2023-001260f01.jpg
case_images: PMC10626754_01_tsaco-2023-001260f01.jpg
case_images: F1
case_images: Initial chest radiograph was done revealing a round radiopaque material which was thought to be a foreign body (marble) at the right upper lung, with fracture of the fourth posterior rib (figure 1).
case_images: PMC10626754_02
case_images: Repeat radiograph after 6 hours. Developing pulmonary contusion noted. AP, anteroposterior.
case_images: tsaco-2023-001260f02.jpg
case_images: PMC10626754_02_tsaco-2023-001260f02.jpg
case_images: F2
case_images: The patient was admitted and a repeat chest radiograph was taken after 6 hours (figure 2).
case_images: Chest CT. Rounded radiopaque foreign body seen in the right upper lung field with gunshot fracture involving the posterior aspect of the fourth rib. There was also pulmonary contusion in the right upper lobe and a fluid density at the right posterior pleural space attributed to a hemothorax.
case_images: tsaco-2023-001260f03.jpg
case_images: PMC10626754_02_tsaco-2023-001260f03.jpg
case_images: F3
case_images: There was also pulmonary contusion on the right upper lobe and a fluid density at the right posterior pleural space attributed to a hemothorax (figure 3).
case_images: PMC10626754_03
case_images: Intraoperative image showing the marble perforating the lung parenchyma.
case_images: tsaco-2023-001260f04.jpg
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case_images: F4
case_images: Repair of the lung injury was done (figure 4).
case_images: PMC10626754_04
case_images: Postoperative day 1 radiograph. Shown is a fully expanded lung without pneumohemothorax. AP, anteroposterior.
case_images: tsaco-2023-001260f05.jpg
case_images: PMC10626754_04_tsaco-2023-001260f05.jpg
case_images: F5
case_images: The patient was started on incentive spirometry and chest tube output was monitored daily (figure 5).
case_images: Postoperative day 4. Shown are fully expanded lungs and total regression of pulmonary contusion.
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case_images: F6
case_images: A repeat chest radiograph showed clear and fully expanded lung (figure 6).
case_images: PMC10626754_05
case_images: Chest radiograph on follow-up consult showed a normal study.
case_images: tsaco-2023-001260f07.jpg
case_images: PMC10626754_05_tsaco-2023-001260f07.jpg
case_images: F7
case_images: Repeat radiograph showed a normal study (figure 7).