Patient 22 years , male , was admitted yesterey because thorax gun shot with entry site wound in right subclavicular area and the bullet get lodge posteriously in left sbscapular area .He was stable .Rx of thorax = bilateral pneumothorax both grade I-II ,neither mediastinal widening or emphysema .normal neck auscultation .
Treated with bilateral thorax seal drainage ,we permormed esophageal, endoscopy and esophagogram both neither perforation or blood or spillage.
The questions are :
-You explore mediastinum as a rule because the bullet have gone through it by itself just in case of unsuspected injury .
-you first perform A.C.T. with contrast
-you prefer echodopler
-you prefer angiography
-you prefer all or some of the forementionated studies before to take decision for to operate or not.
-whats is the reliability and the benefit-cost relations of the called methods in the case that I have presented .