Shot gun injuries: Fatal massive haemothorax following traumatic haemoperitoneum and trans-diaphragmatic blood migration.

Authors

Paranavidana Roshel Claude Wijenayaka, Ajith Rathnaweera

Published in

The Medico-legal journal. Volume 94. Issue 3. Pages 212-215. Epub Jul 10, 2026.

Abstract

Shotgun injuries provide a unique challenge to both forensic pathology and acute clinical care due to their complex internal ballistic behaviour and variable injury patterns. This report describes a case of a 33-year-old man who initially presented with apparent haemodynamic compensation following a mid-range abdominal shotgun injury; subsequently, he developed rapid respiratory deterioration and died. Post-mortem examination revealed a massive left-sided haemothorax caused not by direct thoracic injury, but by trans-diaphragmatic migration of blood from the abdominal cavity through multiple perforations of the left hemidiaphragm. This case highlights the forensic and clinical importance of the thoraco-abdominal transitional region, illustrating how seemingly localised abdominal trauma may cause fatal thoracic compromise. It further emphasises the potential for delayed and unexpected deterioration, as well as the medico-legal implications in interpreting such cases.

PMID:
42433077
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

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