Extraction of a bullet floating in the pulmonary artery after a gunshot wound

Caushi, Fatmir; Skenduli, Ilir; Mezini, Arian; Rulli, F

doi:10.1177/0300060520985661

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Generally, the bullet leaves the body through an exit opposite to its entry. However, the bullet path can be altered after bouncing off an internal structure and it can be retained in the body [3]. In this study, we have discussed the unusual wandering bullet path in a loose-contact suicidal handgun wound.…”

Section: Introductionmentioning

confidence: 94%

Wandering Bullet Embolization in Suicidal Near-Contact Gunshot Wound

Kasim¹,

Alzubaidi²,

Zakari³

et al. 2022

Cureus

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Suicidal firearm injuries with bullet embolization following wandering bullet path are infrequent findings where the penetrated bullet could not be detected in the expected location. If this condition exists, one entrance wound will be present without an exit wound. Through necro-radiographs and postmortem autopsy, forensic experts can determine the nonlinear trajectory of the bullet. To understand the internal bullet path properly, forensic experts should interpret the medicolegal investigation results in the context of tissue and ballistics factors. Various medical specialties, including forensic experts, should be aware of the possibility of the nonlinear bullet trajectory and the possibility of bullet embolization in distant sites in order to save lives and/or interpret the collected evidence to support the justice in such uncommon incident.

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Section: Introductionmentioning

confidence: 94%

Wandering Bullet Embolization in Suicidal Near-Contact Gunshot Wound

Kasim¹,

Alzubaidi²,

Zakari³

et al. 2022

Cureus

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show abstract

“…Patients presenting with severe thoracic injury secondary to penetrating trauma require immediate resources and rapid decision-making by trauma centers and teams [ 1 , 2 ]. Implementing trauma systems has significantly impacted the quality and outcomes of medical and critical care, including managing rare trauma injuries [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Arterial Bullet Embolization Secondary to Direct Cardiac Injury in Penetrating Chest Trauma: A Rare Challenging Case Report

Mashayekhi

Waheed

Kennedy

2021

Cureus

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Severe thoracic injury secondary to penetrating trauma requires prompt resources and rapid decisionmaking by trauma centers and teams. Implementing trauma systems has significantly impacted medical and critical care quality and outcomes, including managing rare trauma injuries. We describe a report of a rare case of a 21-year-old man with a gunshot wound to the chest with injuries to the right pulmonary hilum requiring pneumonectomy and to the left atrium with bullet embolism to the right common iliac artery. In addition, the systematic approach where each phase of the individual's treatment --prehospital, emergency room, running room, and intensive care --was positively affected by the implementation, development, and progressive maturation of a trauma system is also explained.

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Diagnostic and therapeutic considerations in cases of civilian intravascular ballistic embolism: a review of case reports

Russell,

Vieira,

Freeman

et al. 2024

Trauma Surg Acute Care Open

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BackgroundBallistic embolism (BE) is a rare complication of firearm injuries notoriously associated with a vexing clinical picture in the trauma bay. Unless considered early, the associated confusion can lead to needless delay in the management of the patient with a gunshot wound. Despite this known entity, there is a relative paucity of high-grade evidence regarding complications, management, and follow-up in these patients.MethodsAn electronic database literature search was conducted to identify cases of acute intravascular BE in pediatric and adult civilians occurring during index hospitalization, filtered to publications during the past 10 years. Exclusion criteria included non-vascular embolization, injuries occurring in the military setting, and delayed migration defined as occurring after discharge from the index hospitalization.ResultsA total of 136 cases were analyzed. Nearly all cases of BE occurred within 48 hours of presentation. Compared with venous emboli, arterial emboli were significantly more likely to be symptomatic (71% vs. 7%, p<0.001), and 43% of patients developed symptoms attributable to BE in the trauma bay. In addition, arterial emboli were significantly less likely to be managed non-invasively (19% vs. 49%, p<0.001). Open retrieval was significantly more likely to be successful compared with endovascular attempts (91% vs. 29%, p<0.001). Patients with arterial emboli were more likely to receive follow-up (52% vs. 39%) and any attempt at retrieval during the hospitalization was significantly associated with outpatient follow-up (p=0.034). All but one patient remained stable or had clinically improved symptoms after discharge.ConclusionConsideration for BE is reasonable in any patient with new or persistent unexplained signs or symptoms, especially during the first 48 hours after a penetrating firearm injury. Although venous BE can often be safely observed, arterial BE generally necessitates urgent retrieval. Patients who are managed non-invasively may benefit from follow-up in the first year after injury.

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Extraction of a bullet floating in the pulmonary artery after a gunshot wound

Cited by 3 publications

References 4 publications

Wandering Bullet Embolization in Suicidal Near-Contact Gunshot Wound

Wandering Bullet Embolization in Suicidal Near-Contact Gunshot Wound

Arterial Bullet Embolization Secondary to Direct Cardiac Injury in Penetrating Chest Trauma: A Rare Challenging Case Report

Diagnostic and therapeutic considerations in cases of civilian intravascular ballistic embolism: a review of case reports

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