Venous bullet embolism and subsequent endovascular retrieval – A case report and review of the literature

Carter, Cullen O.; Havens, Joaquim M.; Robinson, William P.; Menard, Matthew T.; Gates, Jonathan D.

doi:10.1016/j.ijscr.2012.06.011

Cited by 21 publications

(55 citation statements)

References 8 publications

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“…In the literature, there is a case report regarding the migration of a bullet, which was retained in the body, as an embolism from the periphery to the center through the venous flow (4). Considering this related study in the literature, we have not seen any bullet migration as we observed in our case.…”

Section: Discussionsupporting

confidence: 66%

Bullet Migration from Fascial Space of Femoral Vein to Common Iliac Vein Bifurcation

Şener¹,

Kara²,

Malkoç³

et al. 2017

J Emerg Med Case Rep

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Introduction: Migration of a retained bullet in the body is rare. Some studies have reported regarding embolism induced by intravascular bullet migration. Here we present a case of lead bullet migration through the external surface of the right femoral vein. Case Report: A 31-year-old male was referred to our department for clinical forensic medical evaluation. He was assaulted while working at his office and thus was subsequently taken to the emergency department. Physical examination revealed that the bullet first entered from the left thigh and passed through the medial part of the right thigh with its own kinetic energy, and after 7 h, it passively moved up to the common iliac vein via the femoral space of the right femoral vein. Conclusion: This case report is important as it demonstrated that the lead bullet retained in the body may have passively migrated toward proximal and abdomen via the external surface of the vein between the fascia and intermuscular structures.

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Section: Discussionsupporting

confidence: 66%

Bullet Migration from Fascial Space of Femoral Vein to Common Iliac Vein Bifurcation

Şener¹,

Kara²,

Malkoç³

et al. 2017

J Emerg Med Case Rep

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“…Many authors reported cases of venous BE mostly managed by endovascular techniques [10][11][12][13] while others were managed by open surgery [14][15][16][17][18][19][20] or nonoperatively [5,21]. Open surgery was either used as a primary procedure or after failure of endovascular intervention.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary bullet embolism following cardiac gunshot wound: case report of a bullet that traversed the heart twice

Bakir¹,

Othman²,

Taha

2020

Cardiothorac Surg

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Background: Cardiac gunshot wounds with bullet embolism (BE) into the pulmonary artery are rare. Most pulmonary BE follow injuries of peripheral veins without concomitant cardiac injury. Herein, we describe a case of cardiac gunshot injury in which the bullet migrated from right atrium through the inferior vena cava down to right internal iliac vein and back to the left pulmonary artery. Such bullet migration is too rare and unusual and to our knowledge not reported before. Case presentation: On March 4, 2019, a man of 39 had a bullet injury during celebratory gunfire. He was clinically stable with entrance on right posterior chest but no exit. Chest CT scan showed a bullet in the right atrium. The next day, the bullet migrated to the right pelvis as shown by plain chest and pelvic radiographs. CT angiography 3 weeks afterwards displayed the bullet in the right internal iliac vein. Meanwhile, the patient was asymptomatic, thus discharged home. However, 3 months later, he was readmitted because of chest pain, dyspnea, and sweating. A repeat chest CT scan showed the bullet in the left lower lobe pulmonary artery. Hence, pulmonary BE was suspected and eventually a 0.36 bullet was removed via left thoracotomy. Conclusions: This is a case of symptomatic venous BE with typical diagnostic criteria (a small low-velocity bullet with inlet but no exit located away from anticipated trajectory with migration proven by serial radiographs). Endovascular removal was preferred but was not available. BE of the heart is exceedingly rare. Hence, diagnosis requires a high degree of clinical awareness.

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“…Low velocity bullet injury, as in civilian firearms, usually lodge within the body tissues, and rarely into the vascular tree. Vascular embolization of a bullet generally occurs when a small caliber, low velocity bullet breaches only one wall of a vessel, getting lodged within the vessel . The bullet generally follows the direction of blood flow (antegrade embolism).…”

Section: Discussionmentioning

confidence: 99%

An unusual shot‐retrograde transthoraco‐abdominal venous bullet embolization

Salahuddin

Faizal

Koshy

et al. 2019

Cathet Cardio Intervent

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Venous bullet embolism and subsequent endovascular retrieval – A case report and review of the literature

Abstract: Venous bullet emboli should be removed endovascularly whenever technically possible.

Cited by 21 publications

References 8 publications

Bullet Migration from Fascial Space of Femoral Vein to Common Iliac Vein Bifurcation

Bullet Migration from Fascial Space of Femoral Vein to Common Iliac Vein Bifurcation

Pulmonary bullet embolism following cardiac gunshot wound: case report of a bullet that traversed the heart twice

An unusual shot‐retrograde transthoraco‐abdominal venous bullet embolization

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