Pulmonary Arterial Embolus by an Unusual Wandering Bullet

Abstract

We report on a wandering bullet embolus to the left pulmonary artery after it had first passed from the right ventricular to the right renal vein via the inferior vena cava. Its presence in the left pulmonary artery was confirmed by pulmonary angiography. Hemorrhage due to the right ventricular wound was controlled by a median sternotomy and the bullet was extracted by left lateral thoracotomy. Intravascular migratory bullets continue to be a surgical curiosity. Clinical diagnosis may present a difficult aspect in emergency practice and angiography is mandatory. The removal of foreign bodies is recommended by the majority of authors.

Impaction of a Shrapnel Splinter in the Common Bile Duct After Migrating from the Right Thoracic Cavity: Report of a Case

“…In July 1978, percutaneous cholangiogram demonstrated a high-density mass located in a dilated common bile duct the thoracic cavity they can enter the esophagus, blood vessels (pulmonary artery), or pericardial space. [9][10][11] However, it is very rare for a piece of shrapnel to migrate from the right thoracic cavity toward the diaphragm and liver and settle in the CBD causing obstructive jaundice, as seen in our patient. In fact, there have been only eight such reports in the world literature.…”