Bullet Embolus to the Heart after Gunshot Wound to the Neck: A Case Report

2007 ◽  
Vol 73 (12) ◽  
pp. 1245-1246 ◽  
Author(s):  
Jacob M. Breeding ◽  
R. Stephen Smith ◽  
Jonathan M. Dort

A 43-year-old woman presented with gunshot wounds to the neck, chest, and left thigh. Computed tomography of the neck and chest with intravenous contrast revealed a left common carotid pseudoaneurysm and a foreign body in the right atrium. Preoperative chest x-ray and CT scan confirmed a metallic foreign body in the right heart. At median sternotomy, the intracardiac foreign body could not be located using fluoroscopy. The foreign body (bullet) was subsequently removed in the cardiac catheterization laboratory using a percutaneous transvenous basket extraction through a right femoral vein cutdown.

2021 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
Jennifer Shortland

Intra-cardiac foreign bodies are a rare occurrence and there is minimal literature on retention of sutures following cardiac surgery. This is an unusual case of a retained intracardiac prolene suture following surgical correction of Tetralogy of Fallot in a 6 month old patient. The patient had an uneventful post-surgical recovery but a foreign body was identified on a routine post-operative transthoracic echocardiogram. Due to the uncertain nature of the structure, the patient underwent fluoroscopy, chest X-ray and a cardiac CT which were unable to identify the nature of the structure. The best modality for identification was echocardiography, which consistently demonstrated the origin, and course of the suture. Due to a high level of suspicion and consistent findings on echocardiograms, the patient underwent surgical exploration 10 days following surgery and a prolene suture was identified originating in the right upper pulmonary vein extending though the mitral and aortic valve to the transverse aortic arch. This was thought to be from the purse string suture used for the left ventricular vent inserted via the right upper pulmonary vein during surgery.


2016 ◽  
Vol 52 (1) ◽  
pp. 73-76 ◽  
Author(s):  
Daniel Joseph Santiago Nucci ◽  
Julius Liptak

A dog was referred to Alta Vista Animal Hospital with a porcupine quill penetrating the right ventricle. The presenting complaint was tachypnea and dyspnea secondary to bilateral pneumothorax. Computed tomography revealed bilateral pneumothorax without evidence of quills. A median sternotomy was performed and the quill was removed. The dog recovered uneventfully. Quill injuries are common in dogs; however, intracardiac quill migration is rare. Dogs without evidence of severe cardiac injury secondary to intracardiac foreign bodies may have a good prognosis.


2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mohammad Ashkan Moslehi ◽  
Mohammad Hadi Imanieh ◽  
Ali Adib

Foreign body aspiration (FBA) is a common incidence in young children. Leeches are rarely reported as FBA at any age. This study describes a 15-year-old female who presented with hemoptysis, hematemesis, coughs, melena, and anemia seven months prior to admission. Chest X-ray showed a round hyperdensity in the right lower lobe. A chest computed tomography (CT) demonstrated an area of consolidation and surrounding ground glass opacities in the right lower lobe. Hematological investigations revealed anemia. Finally, bronchoscopy was performed and a 5 cm leech was found within the rightB7-8bronchus and removed by forceps and a Dormia basket.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Andrew Ertel ◽  
Jeffrey Nadelson ◽  
Adhir R. Shroff ◽  
Ranya Sweis ◽  
Dean Ferrera ◽  
...  

Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exposure to patients and operators. Methods. Radiation doses to a simulated operator were measured with a RadCal Dosimeter in the cardiac catheterization laboratory. The mock patient was a 97.5 kg fission product phantom. Three lead-free drape designs were studied. The drapes were placed just proximal to the right wrist and extended medially to phantom’s trunk. Simulated diagnostic coronary angiography included 6 minutes of fluoroscopy time and 32 seconds of cineangiography time at 4 standard angulated views (8 s each), both 15 frames/s. ANOVA with Bonferroni correction was used for statistical analysis. Results. All drape designs led to substantial reductions in operator radiation exposure compared to control (P<0.0001). The greatest decrease in radiation exposure (72%) was with the L-shaped design. Conclusions. Dedicated radial shielding drapes decrease radiation exposure to the operator by up to 72% during simulated cardiac catheterization.


2018 ◽  
Vol 4 (2) ◽  
pp. 45
Author(s):  
Isnu Pradjoko ◽  
Chandra Jaya

Background: Aspiration of a tracheobronchial foreign body is a serious and fatal event. Progress in terms of prevention, first aid, and endoscopic technology, caused a decline of almost 20% of deaths from foreign body aspiration that occurred in the United States. Statistically, the percentage of foreign body aspirations based on their respective location is: 5% hypopharynx, 12% larynx-trachea, and 83% bronchus. Most cases of foreign body aspiration occur in children aged <15 years old; about 75% of foreign body aspirations occur in children aged 1-3 years. The female-to-male ratio is 1.4:1. Case: A 11-year-old boy swallowed needles while playing flashlight about 2 hours before coming to Pulmonary Emergency Room of Dr. Soetomo General Hospital. Discussion: Chest X-ray examination found a shadow of metal density projected in the right lung. Fiber optic bronchoscopy (FOB) was performed for diagnostic and therapeutic indication to see the presence of a foreign body in the airway and remove the foreign body, but failed. When the needle was extracted, the patient coughed that the needle bounces to the supramaxilla area. FOB with nasal cavity approach successfully extracted the corpus alienum. Conclusion: Corpus alienum of airway sometimes is difficult to extract. FOB with nasal cavity approach can be done to manage corpus alienum in the upper airway that moved from lower airway when FOB was performed.


2016 ◽  
Vol 8 (4) ◽  
pp. 543-549 ◽  
Author(s):  
Razan Shamoon ◽  
Habib Habib ◽  
Upamanyu Rampal ◽  
Aiman Hamdan ◽  
Mahesh Bikkina ◽  
...  

A 24-year-old male with past medical history of hypoplastic left heart syndrome and staged reconstructive surgery in infancy culminating in the Fontan circulation presented to the hospital with a chief complaint of chest pain described as an “elephant sitting” on his chest. Initial 12-lead electrocardiogram revealed 2-mm ST segment elevation in inferior leads, 3-mm ST-segment elevation in anterolateral precordial leads V3 and V4, and 2-mm ST-segment elevation in V5 and V6, with right axis deviation. He was transported emergently to the cardiac catheterization laboratory where coronary angiography revealed complete occlusion of multiple anomalous branches of the right coronary system with hazy appearance suggesting the presence of thrombotic material. An aspiration catheter was used successfully to reestablish TIMI grade III flow. The patient was treated with aspirin, brilinta (ticagrelor), and anticoagulation with vitamin K antagonism to prevent recurrent thromboembolic complications.


2020 ◽  
Vol 2 (1) ◽  
pp. 18-23
Author(s):  
Naufal Hilmy Imran ◽  
Wahyudi

Introduction: Intracranial foreign bodies are usually caused by trauma that penetrates the cranium. Gunshot wounds are the most common cause, while non-missile intracranial penetration is rare. The patient’s clinical condition highly depends on the mechanism, anatomical location of the lesion, and related injuries. Possible complications include intracerebral hemorrhage, contusion, major injury on the vascular, and meningitis. In this article, we report case of intracerebral nail extraction from a patient with right cerebral foreign body. Case presentation: A 22-year-old man with a history of unspecified schizophrenia reported with reduced awareness accompanied by weakness of his left limb. During a head CT scan of the head, there are several tubular foreign bodies in the right cerebral. Craniotomy for foreign body extraction and drainage of the cerebral abscess is immediately performed. Four days after surgery, the patient had increased awareness, although there was no significant improvement in motor strength. One month after discharged from hospital there was slight improvement in motor strength. Conclusion: Extraction of foreign bodies by a surgical procedure is mandatory and should be performed thoroughly. The administration of antibiotics, anticonvulsants, physiotherapy, and psychiatric follow-up should be added to the treatment of this patient.


2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Leire Zarain Obrador ◽  
Yusef Mohamed Al-Lal ◽  
Jorge de Tomás Palacios ◽  
Iñaki Amunategui Prats ◽  
Fernando Turégano Fuentes

Cardiac injuries caused by knives and firearms are slightly increasing in our environment. We report the case of a 43-year-old male patient with a transmediastinal gunshot wound (TGSW) and a through-and-through cardiac wound who was hemodynamically stable upon his admission. He had an entrance wound below the left clavicle, with no exit wound, and decreased breath sounds in the right hemithorax. Chest X-ray showed the bullet in the right hemithorax and large right hemothorax. The ultrasound revealed pericardial effusion, and a chest tube produced 1500 cc. of blood, but he remained hemodynamically stable. Considering these findings, a median sternotomy was carried out, the through-and-through cardiac wounds were suture-repaired, lung laceration was sutured, and a pacemaker was placed in the right ventricle. The patient had uneventful recovery and was discharged home on the twelfth postoperative day. The management and prognosis of these patients are determined by the hemodynamic situation upon arrival to the Emergency Department (ED), as well as a prompt surgical repair if needed. Patients with a TGSW have been divided into three groups according to the SBP: group I, with SBP>100 mmHg; group II, with SBP 60–100 mmHg; and group III, with SBP<60 mmHg. The diagnostic workup and management should be tailored accordingly, and several series have confirmed high chances of success with conservative management when these patients are hemodynamically stable.


Cardiology ◽  
2015 ◽  
Vol 132 (1) ◽  
pp. 65-67
Author(s):  
Dmitry Zateyshchikov ◽  
Elvira Fattakhova ◽  
Vladimir Demchinsky ◽  
Tatiana Baklanova ◽  
Victor Serebruany

Background: Coronary stent infections in general and stent abscesses (SAs) in particular are rare but often deadly complications. Most SAs manifest with fever and chest pain within 30 days after intervention and require antibiotics and stent removal. Case Report: A 45-year-old man with second ST elevated myocardial infarction and cardiogenic shock was admitted to a hospital that had no cardiac catheterization laboratory. The patient underwent fibrinolytic therapy with alteplase but died 1 h later. His medical history revealed posterior myocardial infarction 7 years before, which had been successfully treated with a bare metal stent of the right coronary artery. The post-discharge observation had been unremarkable with no evidence of ischaemia or infection but gross non-compliance. Autopsy revealed complete closure of the left main coronary artery and a surprise additional finding, namely SA; the stented portion of the artery was enveloped by an abscess, and purulent material completely occluded the stent, which was floating in pus. Impressions: Since coronary angioplasty is so common, the incidence of late silent SA is probably higher than expected, especially considering that there is often a lack of clinical manifestations. Clinicians should be cognizant of this complication. More attention may be required to assess the condition of existing stents during repeated interventions. Gross non-compliance and/or early withdrawal from dual anti-platelet therapy may be directly responsible for the development of silent delayed SA.


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