Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Gunshot bullet embolus with pellet migration from the left brachiocephalic vein to the right ventricle: a case report Nicholas Greaves | Greaves Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 36 http content 18 1 36 SCANDINAVIAN JOURNAL OF Et emergency medicine CASE REPORT Open Access Gurpshot bullet embolus with pellet migration from the left brachiocephalic vein to the right ventricle a case report Nicholas Greaves Abstract We report the case of a 16 year old male who was the victim of a drive by shooting sustaining the rare but recognised complication of cardiovascular bullet embolism. He was seen as a trauma call in the emergency department and CT scanning revealed 70 shotgun pellets scattered throughout left sided sub-cutaneous tissues of the head and neck and more significantly a single pellet within the right atrium. It is believed to have got there via injury to the left brachiocephalic vein which was demonstrated by extravasation of contrast on the CT scan. He remained stable throughout admission and the injury was managed conservatively. Serial scanning showed the pellet had subsequently migrated into the right ventricle where it has remained since presumably having become epithelialised. This case report highlights the importance of repeated scanning for the possibility of projectile migration within the cardiovascular system in similar cases of penetrating injury. Introduction The diagnosis and management of penetrating wounds of the great vessels continues to be a major surgical challenge. Their presentation varies from moribund patients to completely stable ones in whom the diagnosis is often missed unless subtle clues are noted 1 . This case study documents the conservative management of a patient who developed a venous bullet embolus after being shot with a shotgun. We aim to review some of the literature on bullet emboli to raise awareness of their existence investigation and management. With the amount of gun crime increasing the likelihood of seeing such a case is higher. Such a complication can have significant morbidity and mortality .
