Gunshot Wound on Hepatic Ultrasound Note the echogenic foci (orange arrow) adjacent to the hepatic vein with reverberation artifact (comet tails) posterior (between green arrows)-consistent with metallic FB. Patient had shotgun injury to left chest with approximately 8 pellet entrance wounds on left anterior chest. Vitals stable. no PMH. SC window otherwise OK? Patient has hemopericardium (mixed echogenic/anechoic). Not a fat pad. Note it wraps around toward the left ventricle. Key points: 1. Use identification of artifacts to your advantage. 2. Hemopericardium in acute phase can be echogenic. Don't miss these! Dr. Robert Jones @RJonesSonoEM #Gunshot #GSW #Liver #Ultrasound #Hemopericardium #RUQ #Clinical #ForeignBody #FB #Pellet #POCUS
