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This report describes a case of a 33-year-old man who initially presented with apparent haemodynamic compensation following a mid-range abdominal shotgun injury; subsequently, he developed rapid respiratory deterioration and died. Post-mortem examination revealed a massive left-sided haemothorax caused not by direct thoracic injury, but by trans-diaphragmatic migration of blood from the abdominal cavity through multiple perforations of the left hemidiaphragm. This case highlights the forensic and clinical importance of the thoraco-abdominal transitional region, illustrating how seemingly localised abdominal trauma may cause fatal thoracic compromise. It further emphasises the potential for delayed and unexpected deterioration, as well as the medico-legal implications in interpreting such cases.<\/jats:p>","DOI":"10.1177\/00258172261448062","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T06:41:26Z","timestamp":1783752086000},"page":"212-215","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shot gun injuries: Fatal massive haemothorax following traumatic haemoperitoneum and trans-diaphragmatic blood migration"],"prefix":"10.1177","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2071-8362","authenticated-orcid":false,"given":"Paranavidana Roshel Claude","family":"Wijenayaka","sequence":"first","affiliation":[{"name":"Office of the Judicial Medical Officer, National Hospital Galle, Galle, Sri Lanka"},{"name":"Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7418-2981","authenticated-orcid":false,"given":"Ajith","family":"Rathnaweera","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka"},{"name":"Department of Forensic Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"issue":"11","key":"e_1_3_2_2_2","article-title":"A half-century analysis of firearm-related mortality trends in the United States: a retrospective study utilizing national data (1968\u20132022)","volume":"16","author":"Akinyemi OA","year":"2024","unstructured":"Akinyemi OA, Ogundare T, Wedeslase T, et al. A half-century analysis of firearm-related mortality trends in the United States: a retrospective study utilizing national data (1968\u20132022). Cureus 2024; 16(11): e74228.","journal-title":"Cureus"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0379-0738(86)90077-0"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1355-0306(97)72200-7"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/1353-1131(95)90006-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S45443"},{"key":"e_1_3_2_7_2","first-page":"102207","article-title":"Hemothorax resulting from hemorrhagic degeneration of giant uterine leiomyomata: a rare variant of pseudo-Meigs\u2019 syndrome","volume":"55","author":"Huang L","year":"2025","unstructured":"Huang L, Pradhan T, Epelbaum O. Hemothorax resulting from hemorrhagic degeneration of giant uterine leiomyomata: a rare variant of pseudo-Meigs\u2019 syndrome. 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