A twenty-year old man was found supine on Thompson Creak Trail with a bullet would. The entrance of the wound was on the left lateral side 1 cm above the third rib. The exit wound was 5 cm above the belly button in the umbilical region. While tracing the bullet path you notice at the entrance the bullet travels in the frontal plane with a 45-degree downward angle. On inspection of the right side of the rib cage by x-ray you observe the 8th rib fractured. Fragments of the bullets are then traced to the final exit wound. What is the leading differential diagnosis (and why) and what are three plausible alternatives and how would you rule them out.
Leading cause of death: Blood loss
-Went to the 3rd rib on left lateral side where the heart is
Most likely severed arteries causing internal bleeding
Alternatives
1) Shock
Would of happened after the heart was hit
2) Lung puncture
Would of happened after the heart was hit, since it was going at an angle
3) Punctured fluid organs which lead to poisoning
Once again, would have happened after the heart was hit
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