Surgical management of late bullet embolization from the abdomen to the right ventricle: Case report

dc.creatorJosé Antonio Díaz Elizondo
dc.creatorFrancisco Xavier Treviño Garza
dc.date2017
dc.date.accessioned2018-10-18T19:54:18Z
dc.date.available2018-10-18T19:54:18Z
dc.descriptionIntroduction Secondary embolus from gun projectile is a rare entity, it represents a clinical and therapeutic dilemma because the potential complications involving central and peripheral circulation. Each case reported in the literature represents a challenge because their unique and different clinical scenarios. Presentation of case We present the management of a 33-year-old man with past history of a gunshot wound on left flank with no evidence of any exit wounds, treated with exploratory laparotomy without removing the gunshot bullet from the abdomen. The patient presents 6 years later with non-productive cough and retrosternal pain with no other symptoms; the patient underwent a chest x-ray, electrocardiogram, thoracoabdominal CT, echocardiogram and cardiac catheterization and showed a bullet in the right ventricular floor. The projectile was extracted by sternotomy with extracorporeal circulation through the right atrium, without any complications. Discussion In 1834, Thomas David reported for the first time a wood-fragment embolization. There have been reported less than 200 cases including embolization of other materials; most of the gunshot bullet embolization cases reported on literature were reported after war. Clinical manifestations are associated with the anatomical site of embolism and mortality rate for a retained bullet is 6% associated with complication in 25% of cases. Mortality rate decreases to 1–2% if the bullet is removed. Conclusion There are no established guidelines about the management of migrating foreign bodies or bullets, however, conservative, endovascular and surgical management have been proposed. In the cases of bullet embolization to the thoracic cavity, surgery represents a safe, low risk approach with high success rates. © 2017
dc.identifier.doi10.1016/j.ijscr.2017.08.049
dc.identifier.endpage320
dc.identifier.issn22102612
dc.identifier.startpage317
dc.identifier.urihttp://hdl.handle.net/11285/630275
dc.identifier.volume39
dc.languageeng
dc.publisherElsevier Ltd
dc.relationhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85029057497&doi=10.1016%2fj.ijscr.2017.08.049&partnerID=40&md5=0b207eab67d4fbc59a178ea9f8bf5863
dc.relationInvestigadores
dc.relationEstudiantes
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0
dc.sourceInternational Journal of Surgery Case Reports
dc.subjectabdominal radiography
dc.subjectadult
dc.subjectArticle
dc.subjectbullet embolization
dc.subjectcase report
dc.subjectclinical article
dc.subjectcoughing
dc.subjectechocardiography
dc.subjectelectrocardiogram
dc.subjectembolism
dc.subjectexploratory laparotomy
dc.subjectextracorporeal circulation
dc.subjectflank
dc.subjectfollow up
dc.subjectgunshot injury
dc.subjectheart catheterization
dc.subjectheart right atrium
dc.subjectheart right ventricle
dc.subjecthuman
dc.subjectlaparotomy
dc.subjectmale
dc.subjectpriority journal
dc.subjectretrosternal pain
dc.subjectsternotomy
dc.subjectthorax radiography
dc.subject.classification7 INGENIERÍA Y TECNOLOGÍA
dc.titleSurgical management of late bullet embolization from the abdomen to the right ventricle: Case report
dc.typeArtículo
refterms.dateFOA2018-10-18T19:54:18Z

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