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Fig. 4. —17-year-old girl with right upper quadrant gunshot injury. Axial CT image reveals subcutaneous emphysema in superficial tissues of right flank (straight arrow). Linear, irregular low-attenuation area in liver (curved arrow) is consistent with laceration from missile. Extrapolating missile trajectory indicates that projectile must have traversed diaphragm. Diaphragmatic injury was confirmed at surgery. Streak artifact emanates from bullet fragment in posterior soft tissues of thorax.