Delayed presentation of a firearm injury in a patient with recent use of phencyclidine: A case report

The rapid delivery of care for penetrating traumatic injury, such as gunshot wounds, is essential to minimizing the morbidity and mortality rate. It is highly unusual for a patient who has sustained a firearm injury to present over 24 h after the event and even more unusual for the patient to be amnestic to the event. We report a case of a 44-year old woman who presented to the Emergency Department (ED) with an abdominal firearm injury sustained over 24 h earlier. The patient had no recollection of the events surrounding this injury. An abdominal Computed Tomography (CT) scan confirmed an intra-abdominal injury consistent with ballistic trauma. Upon further questioning, the patient continued to deny having sustained a gunshot but did reveal that she smoked phencyclidine (PCP) one day earlier with her boyfriend. The patient was admitted for emergency laparotomy and bowel resection and had a prolonged hospital course due to development of necrotizing soft tissue infection of the abdominal wall and an enterocutaneous fistula. This case represents an unusual delayed presentation of ballistic trauma after recreational consumption of PCP.