Lead Toxicity from a Retained Bullet

Marquez, Jose I; Schindlbeck, Michael

doi:10.1056/nejmicm1804726

Cited by 5 publications

(1 citation statement)

References 0 publications

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“…125,199 Plumbism is more likely if fragments are retained within a joint space, bone, or intervertebral disk, though the latter is less common. 17,89,181,182,[200][201][202] Lead is highly soluble in synovial fluid, thus retained bullets in intra-articular spaces can lead to both local and systemic effects. 147 After dissolving in synovial fluid, the lead can become deposited in subsynovial tissue, resulting in foreign body reactions, arthritis, chronic irritation and inflammation, and absorption into the systemic circulation.…”

Section: Lead Toxicitymentioning

confidence: 99%

Gunshot Wounds: Ballistics, Pathology, and Treatment Recommendations, with a Focus on Retained Bullets

Baum¹,

Baum²,

Hayward³

2022

ORR

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As the epidemic of gunshot injuries and firearm fatalities continues to proliferate in the United States, knowledge regarding gunshot wound (GSW) injury and management is increasingly relevant to health-care providers. Unfortunately, existing guidelines are largely outdated, written in a time that high-velocity weapons and deforming bullets were chiefly restricted to military use. Advances in firearm technology and increased accessibility of military grade firearms to civilians has exacerbated the nature of domestic GSW injury and complicated clinical decision-making, as these weapons are associated with increased tissue damage and often result in retained bullets. Currently, there is a lack of literature addressing recent advances in the field of projectile-related trauma, specifically injuries with retained bullets. This review aims to aggregate the available yet dispersed findings regarding ballistics, GSW etiology, and treatment, particularly for cases involving retained projectiles.

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