[Intracardial migration of a bullet: diagnosis and management]

Ann Chir. 2002 Apr;127(4):305-9. doi: 10.1016/s0003-3944(02)00745-9.
[Article in French]

Abstract

Venous pellet embolism to the cardia after shotgun wound is a very rare occurrence. Number and size of pellets, at the impact make this migration easier; embolism is asymptomatic and may occur 15 years after the injury. Many problems must be mentioned: mechanics of entry into the heart (own velocity, venous flow), topographic diagnosis (chest X-ray, transthoracic, transoesophageal ultrasound and CT-scan), local outcomes of this projectile (local erosion, clot, endocarditis), destination of a new migration (pulmonary embolism, left heart), indications of extraction, supervision. Extraction musn't be systematic, but only in the event of a patent foramen ovale with a risk of systemic embolism, which clinical outcomes are most serious or in the event of complications. The authors report on a 22 years old patient observation whose treatment was abstention and supervision.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Cardia / pathology*
  • Diagnosis, Differential
  • Embolism / etiology*
  • Embolism / pathology
  • Foreign-Body Migration*
  • Humans
  • Male
  • Risk Factors
  • Wounds, Gunshot / complications*