Bullet Embolization From the Right Internal Jugular Vein to the Right Ventricle

Wong, Sophia; Hockmann, Edgar; Moussa, Fuad; Bertram, Sue

doi:10.1053/j.jvca.2013.02.018

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…Other critical considerations, particularly in emergency settings, include prophylactic antibiotic coverage due to the associated risk of infection, primarily endocarditis. Anticoagulation is also recommended in pulmonary locations for a minimum duration of one year, except in cases of anemic bleeding or hemodynamically unstable patients [10,19,20].…”

Section: Discussionmentioning

confidence: 99%

Projectile Embolism From a Firearm Injury: A Case Report

Zuluaga-Gomez,

Giraldo-Campillo,

González-Arroyave

et al. 2024

Cureus

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Projectile embolism resulting from firearm injuries is a rare but highly lethal complication when not diagnosed early. This report presents a case of projectile embolism from a firearm injury with an unusual entry site, the cerebral venous circulation, which subsequently migrates to the pulmonary circulation with a fatal outcome. A 24-year-old male patient was admitted to a high-complexity hospital due to a gunshot wound. A plain skull computed tomography (CT) revealed a left laminar subdural hematoma and traumatic subarachnoid hemorrhage with multiple metallic fragments embedded in the skull, some penetrating the galeal sinus, with perilesional bleeding. Contrast-enhanced chest tomography showed non-thrombotic embolism of metallic fragments in the pulmonary artery for the apical segment of the left upper lobe and right intraventricular regions. Transthoracic echocardiography revealed a hyperechoic image of 3 mm in the subvalvular apparatus toward the interventricular septum. Subsequently, the patient experienced neurological deterioration with signs of cerebral edema and parieto-occipital epidural hematomas with metallic fragments and projectiles. Measures to counteract cerebral edema were initiated. Later, the patient developed mydriasis, the absence of brainstem reflexes, and experienced cardiac arrest. This report delineates a case of projectile embolism, highlighting a distinctive aspect characterized by an unusual entry point.

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Section: Discussionmentioning

confidence: 99%

Projectile Embolism From a Firearm Injury: A Case Report

Zuluaga-Gomez,

Giraldo-Campillo,

González-Arroyave

et al. 2024

Cureus

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“…Without early diagnosis and treatment, foreign body residue remains a major cause of morbidities, such as subcutaneous emphysema, pneumomediastinum, and hemopneumothorax [9]. Furthermore, an intravascular foreign body can migrate further and reach the brain, heart, or other organs [10, 11]. To avoid these complications, the procedure should be stopped if a catheter fragment escapes during guidewire threading.…”

Section: Discussionmentioning

confidence: 99%

Unexpected Complication of Central Venous Catheter Exchange: Catheter Fragment Migration

et al. 2020

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Tunneled central venous catheter (TCVC) placement is often an easy and uncomplicated procedure. As such, some clinicians pay little attention to the procedure, and different complications occurred. Catheter fragment loss in major vessels is a rare but serious complication of in situ catheter exchange with few reported cases in the literature. Once catheter fragments slip into a deep vein, endovascular retrieval should be attempted, due to its high success rate and minimal associated morbidity. A 37-year-old male patient underwent replacement of his temporary catheter with TCVC through a trans-right-internal-jugular-vein approach for maintenance of dialysis. As a major unintended outcome of the operation, a catheter fragment slipped into the right internal jugular vein, then migrated and lodged in the inferior vena cava. We retrieved it with a gooseneck snare without complications. We report the case hoping to emphasize on and raise awareness of the fact that catheter fragment loss is a completely evitable complication, provided the operator follows the correct safety measures and protocols. However, if catheter fragment loss occurred, the fragment should be retrieved as soon as possible. A gooseneck snare is an ideal option for retrieving catheter fragments that have migrated into deep veins.

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“…En cuanto a otras conductas, a pesar de que no hay ninguna evidencia sólida que lo sugiera como una necesidad, se debe considerar la profilaxis antibiótica por el riesgo de infección asociada, principalmente endocarditis 18,19 . Asimismo, la anticoagulación debe considerarse por un tiempo mínimo de 12 meses, salvo ante la presencia de hemorragia significativa o estado de choque hemorrágico agudo, casos en que deberá contemporizarse 19,20 . Por otra parte, existe el riesgo de toxicidad por plomo, al liberarse este elemento del proyectil durante el transcurso de los años; es más frecuente el reporte de estos casos cuando el proyectil se aloja cerca de membranas sinoviales articulares [21][22][23] .…”

Section: Discussionunclassified

Embolia por proyectil por arma de fuego: a propósito de un caso

Gómez¹,

Estrada

Maldonado

et al. 2020

Rev Colomb Cir

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Introducción. La embolia pulmonar por herida con arma de fuego es potencialmente fatal y una complicación rara que puede presentarse en los servicios de urgencias. En los últimos años, se ha presentado una mayor incidencia por la violencia social civil (85 %) que por las guerras (15 %). Los principales síntomas de los pacientes son dolor torácico, disnea y hemoptisis por la erosión vascular y el infarto pulmonar asociado. Caso clínico. Se presenta el caso de un paciente de 18 años de edad que ingresó por múltiples heridas por proyectiles de arma de fuego, una de ellas con un proyectil alojado en la arteria pulmonar del lóbulo inferior derecho y embolia pulmonar aguda en las ramas arteriales distales al proyectil. Se optó por un tratamiento conservador y la evolución fue adecuada. Discusión. La sintomatología de esta condición depende de la localización, la trombosis asociada, los fenómenos de isquemia y las complicaciones hemorrágicas. Entre las complicaciones de un proyectil de fuego alojado en una arteria pulmonar, están la isquemia, la trombosis, los pseudoaneurismas, la hemorragia, el derrame pleural, la insuficiencia vascular y la endocarditis. La mayoría de los pacientes deben someterse a una intervención quirúrgica cuando el proyectil se aloja en las arterias pulmonares principales o lobares y las compromete; cuando se localiza en las arterias segmentarias y subsegmentarias, tienden a presentar fístulas con el bronquio y vasoespasmo compensatorio, lo que permitiría el manejo conservador.

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Bullet Embolization From the Right Internal Jugular Vein to the Right Ventricle

Cited by 6 publications

References 3 publications

Projectile Embolism From a Firearm Injury: A Case Report

Projectile Embolism From a Firearm Injury: A Case Report

Unexpected Complication of Central Venous Catheter Exchange: Catheter Fragment Migration

Embolia por proyectil por arma de fuego: a propósito de un caso

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