"Heavy Metal": Management of lead toxicity following a gunshot injury with retained lead fragments, a case report

Ilaria Costantini; Massimo Carollo; Lorenzo Losso; Elia Morando; Matilde Bacchion; Giovanni Mantelli; Mauro Pizzuto; Letizia Spagnuolo; Maria Vittoria Ventura; Giorgio Ricci

doi:10.1016/j.toxrep.2023.11.004

"Heavy Metal": Management of lead toxicity following a gunshot injury with retained lead fragments, a case report

Toxicol Rep. 2023 Nov 8:11:444-448. doi: 10.1016/j.toxrep.2023.11.004. eCollection 2023 Dec.

Affiliations

¹ USD Poison Control Center, Azienda Ospedaliera Universitaria integrata, Verona, Italy.
² Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
³ Department of Medical Toxicology Unit and Poison Control Centre, University of Florence, Florence, Italy.
⁴ Department of Medicine, University of Verona, Verona, Italy.

Abstract

There is limited literature on managing chronic lead exposure from non-removable sources such as lead fragments. In this case report, we present the complexities and clinical considerations involved in treating an elderly patient who sustained a comminuted knee fracture due to a gunshot wound, complicated by retained lead fragments. This case highlights the absence of comprehensive guidelines for managing chronic lead exposure when complete fragment removal is impractical. It also emphasizes the importance of a multidisciplinary approach to decision-making, while considering patient autonomy in such unique clinical scenarios.

Keywords: Chelation therapy; Lead poisoning; Poison control centers; Poisons; Toxicology.

Publication types

Case Reports