On examination, he was hemodynamically stable but pale and with a pulse of 82 beats per minute and blood pressure of 113/58 mmHg. The gunshot wound was in the left anterior chest wall, in the third intercostal space. There was no exit wound. Breath sounds in the left chest were diminished, and a small solid object, most likely a round, was palpable in the back (in the posterior chest wall).

Primary survey revealed no other injuries. CT angiogram confirmed a metal foreign body in the left posterior chest, a fractured left ninth rib, an intercostal drain in situ within the left hemithorax, a left pleural effusion with consolidation in the left upper lung, and left lower lung contusion. There was also consolidation at the base of the right lung. There was no pericardial infusion, no spinal injury, and no abdominal injury.

The round was removed under local anesthetic in the trauma room. The patient was transferred to the ward where he received oxygen, analgesia, physiotherapy, intravenous broad-spectrum antibiotics, and two units of packed red blood cells. He made an uneventful recovery.