scholarly journals Bullet embolism in a case of homicide: Case report

2013 ◽  
Vol 141 (3-4) ◽  
pp. 242-246
Author(s):  
Vladimir Zivkovic ◽  
Fehim Jukovic ◽  
Slobodan Nikolic
Keyword(s):  
Femoral Artery ◽  
Gunshot Wound ◽  
Imaging Techniques ◽  
Rare Complication ◽  
Gunshot Wounds ◽  
The Body ◽  
Gunshot Injury ◽  
Thoracic Vertebrae ◽  
Injured Part ◽  
The Right

Introduction. Bullet embolism is a special form of embolism, where embolus is either a bullet or its fragment. Bullet penetrates through the injured part of the body into circulation and then travels to a distant part of the body, until it gets blocked in a vessel of the same diameter as the bullet. Case Outline. We are presenting a case of gunshot injury in a 26?year?old male, found unconscious on the passenger seat, with the gunshot injury of the right hand and hemithorax, who died two hours after admission to hospital. Post?mortem X?ray revealed the presence of a metallic foreign body - a bullet, in the level of the left femoral neck. The autopsy revealed entrance and exit gunshot wounds of the upper third of the right upper arm. There was a second entrance gunshot wound, and the bullet passed through the right hemithorax and the right lung, and then through the intervertebral disc between the eighth and ninth thoracic vertebrae, and also making a complete laceration of the wall of the thoracic aorta, in the right posterior semicircumference. The slightly deformed bul? let, caliber 7.65 mm, was found embedded in the lumen of the vessel at the bifurcation of the deep femoral artery from the left femoral artery. Conclusion. Bullet embolism is a rare complication of gunshot wounds. It should be suspected in any gunshot wound victim without an exit wound, or the lack of a missile in the bullet pathway, or if there are premortem signs or symptoms unexpected for the presumed pathway of the bullet, such as distant ischemia or infection. In these cases, some of postmortem imaging techniques should be used to save time in diagnosis, treatment and at autopsy.

scholarly journals Stage Reconstructive and Restorative Surgical Treatment of Gunshot Wounds of the Groin, Scrotum and Penis (Case Report)

Health of Man ◽  
2021 ◽  
pp. 85-90
Author(s):  
Serhii Golovko ◽  
Oleksandr Savytskiy ◽  
Oleksandr Netrebko ◽  
Yevhen Bidula ◽  
Volodymyr Bondarchuk
Keyword(s):  
Surgical Treatment ◽  
Gunshot Wound ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Gunshot Wounds ◽  
Soft Tissue Defects ◽  
Initial Stage ◽  
The Right ◽  
Upper Third ◽  
Tissue Defects

The frequency of external genital lesions in armed conflicts can reach up to 5%. The complexity of gunshot wounds is the presence of significant soft tissue defects, widespread necrosis around the wound, the possibility of progression in the hours and days after injury, the high probability of infection, and the presence of foreign bodies. The tactics of gunshot wounds are determined by the location, nature and extent of damage to soft tissues, organs, large vessels, nerves, bones and includes several stages. At the initial stage, bleeding is stopped, hematomas and foreign bodies are evacuated, non-viable tissues are removed, drainages are installed and skin defects are closed. The stage of reconstructive surgery can be started when the active wound process is over. In this report, we present a clinical case of a 22-year-old man who received a gunshot wound to the right groin, upper third of the right thigh, perineum and external genitalia in a combat zone of Operation Allied Forces, Ukraine. Bullet wound led to: damage to the skin and subcutaneous tissue in the right buttock, right groin, on the inner surface of the upper third of the thigh, penis (skin defect up to 1/3 of the circumference), scrotum, partial destruction of corpora cavernosa, m. iliopsoas and adductor muscles of the thigh, sphincter of the rectum, crushing of the right testicle. The wound was contaminated with earth and foreign bodies At the initial stage, the patient underwent: primary surgical treatment of a gunshot wound, suturing of cavernous bodies with sutures, fixation of the penis in the groin, removal of the right testicle, tamponade of the wound, sigmostomy (due to sphincter damage). Subsequently, the patient underwent regular surgical treatment of wounds, a vacuum suction system VAC was installed. After 7 months (upon completion of the healing process) suturing of the sigmostoma was performed. After 2 months, the penis and the scrotum were reconstructed. Preoperative examination (ultrasound of the penis with assessment of cavernous hemodynamics, MRI) revealed: post-traumatic scarring of the soft tissues of the right groin, inner surface of the right thigh, buttocks, right inguinal canal of the penis and scrotum, deformation of the cavernous cavity, normal indicators of cavernous blood circulation. In the early postoperative period (2 months after the intervention), the patient indicated satisfaction with the cosmetic and functional results, the preservation of morning erections, moderate discomfort in the penis during erection. Prosthetics of the right testicle are planned. The clinical case once again confirms the need for qualified surgical care during the first “golden” hour and subsequent phased treatment at a specialized level using the VAC therapy system in patients with gunshot wounds and large soft tissue defects. The experience of military medicine demonstrates the importance of involving specialists of various profiles in the treatment of combined gunshot wounds of the pelvis. An important stage of treatment in the wounded is plastic and reconstructive surgery in the long term, which is aimed at improving the functional, cosmetic and psychological results of treatment.

scholarly journals Retrograde venous bullet embolism after thoracic gunshot

2013 ◽  
Vol 12 (4) ◽  
pp. 324-328 ◽  
Author(s):  
Leonardo Pessoa Cavalcante ◽  
Marcos Velludo Bernardes ◽  
Ricardo Dias da Rocha ◽  
Marcos Henrique Parisati ◽  
Jose Emerson dos Santos Souza ◽  
...  
Keyword(s):  
Ct Scan ◽  
Gunshot Wound ◽  
Rare Complication ◽  
Iliac Vein ◽  
X Rays ◽  
Abdominal Injuries ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
The Right

Bullet embolism is a rare complication of penetrating gunshots. We present a case of a 24-year-old man with a gunshot wound in the left scapular area, with no exit wound. Abdominal X-rays and a computed tomography (CT) scan suggested that the bullet was located within the intra-abdominal topography (intrahepatic), but laparotomy revealed no intra-abdominal injuries. After surgery, a sequential CT scan showed that the bullet had migrated to the right internal iliac vein (IIV). Venography confirmed the diagnosis of right IIV embolism and the decision was taken to attempt snare retrieval of the bullet, which was unsuccessful. It was therefore decided to leave the missile impacted inside the right IIV and the patient was put on oral anticoagulation. The patient recovered and was event free at 6 months' follow up.

A Magic Bullet: Bullet Embolism From the Heart to the Femoral Artery

2021 ◽  
pp. 875647932110440
Author(s):  
Michael A. Chen
Keyword(s):  
Computed Tomography ◽  
Transesophageal Echocardiography ◽  
Femoral Artery ◽  
Gunshot Wound ◽  
The Body ◽  
Magic Bullet ◽  
Left Femoral Artery ◽  
Intraoperative Transesophageal Echocardiography ◽  
Clinical Phenomenon

A case study a patient who was emergently evaluated with an intraoperative transesophageal echocardiography after suffering a gunshot wound to the back is provided. This diagnostic examination revealed a left atrium to aorta fistula, due to the path of the bullet through the body. Immediate postoperative imaging with computed tomography revealed that the bullet had embolized to the left femoral artery from which it was later surgically removed. This rare clinical phenomenon of bullet embolization, involving the heart and associated vasculature, is reviewed.

scholarly journals Resection of thrombosed femoral artery over-dimensional stent-graft placed due to multiple arteriovenous fistulas following gunshot wounds

2010 ◽  
Vol 138 (3-4) ◽  
pp. 233-235
Author(s):  
Djordje Radak ◽  
Slobodan Tanaskovic ◽  
Dragoslav Nenezic ◽  
Goran Vucurevic ◽  
Petar Popov ◽  
...  
Keyword(s):  
Stent Graft ◽  
Femoral Artery ◽  
Gunshot Wounds ◽  
Av Fistula ◽  
Graft Placement ◽  
Increased Risk ◽  
Av Fistulas ◽  
Fistula Treatment ◽  
One Year ◽  
The Right

Introduction. Though surgical approach is common in arteriovenous (AV) fistula treatment, endovascular procedures such as stent-graft placement has become more popular in recent years. We aim to present a case of thrombosed femoral artery stent-graft which was placed one year earlier due to multiple AV fistulas following gunshot wounds. Case Outline. A 43-year-old patient was admitted to the Institute for Cardiovascular Diseases 'Dedinje', Belgrade, Serbia, for arteriography. Five years before, he had suffered from six gunshot wounds in his right leg and one year before, in the health centre in Vienna, stent-graft had been placed in the right superficial femoral artery due to multiple AV fistulas. Because of artery dilation proximal to AV fistula location, a large dimensional stent-graft had to be placed (24 mm). After admission, arteriography and Multislice CT (MSCT) angiography revealed thrombotic masses in the stent-graft with intraluminal stenosis of 50%. Extirpation of thrombosed stent-graft was performed followed by Dacron tubular graft 10 mm interposition. On the fifth postoperative day, the patient was discharged from the clinic, and after 3 months, the right leg vascularisation was well preserved. Conclusion. Large dimensional stent-graft placement in patients with mutiple AV fistulas and blood vessel dilation proximal to AV site of communication carries an increased risk of thrombotic events due to turbulent blood flow and parietal thrombosis occurrence. Though stent-graft placement can be a very useful solution in acute AV fistula treatment, the very same thrombosis should be thought of when surgical management is the only treatment choice.

scholarly journals Non-powder Lateral Penetrating Craniocerebral Gunshot Wound in a 10-Year-Old Girl: A Case Report

2020 ◽  
Author(s):  
Christopher Lauren ◽  
Donny Argie ◽  
Elric Brahm Malelak ◽  
Reza Mawardy ◽  
Samuel Edhi Suranta ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Gunshot Wound ◽  
Blood Clot ◽  
Signs And Symptoms ◽  
Gunshot Wounds ◽  
Low Velocity ◽  
Gun Barrel ◽  
Entrance Wound ◽  
Air Gun ◽  
The Right

Abstract Background: Non-powder lateral penetrating craniocerebral gunshot wounds (PCGW) is one of the lethal types of penetrating head injury. The mortality rate is higher in adults than in pediatric populations and influence by the clinical and radiologic findings as the important predictors for prognostication in patients with PGCW. Case Presentation: A 10-year-old girl presented with a gunshot wound to the head 1 day prior. She was accidentally shot by her brother with an air gun from approximately 2 feet from the gun barrel. She develops a loss of consciousness for 30 minutes and weakness over the left arm. In physical examination, the patient Glasgow Coma Scale (GCS) was E3 V5 M6, weakness on the left arm, and an entrance wound over the right temple without an exit wound. The skull X-ray show the pellet fragment and the computed tomography (CT) scan show the bullet track starting from the right frontotemporal towards the left parietooccipital region, damaging both hemispheres with associated intraventricular hemorrhage (IVH). She undergoes a craniotomy procedure to remove the bullet fragment, debridement of the necrotic tissue, and evacuating the blood clot the formed over the bullet track. The patient discharge after postoperative day 7 with good recovery of neurological function and good GCS and Glasgow Outcome Scale (GOS) score. After 6 months follow-up, neither a new deficit nor other signs and symptoms were developed.Conclusions: Non-powder PCGW can cause significant damage to the intracranial compartment, despite its low velocity. The mortality rate in pediatrics is lower than in adults population. The management mandated an urgent surgical procedure to remove any blood clot and debridement of any foreign bodies encountered. Such complications in short- or long term can be developed in any patients and should be treated expectantly.

scholarly journals A case of successful surgical treatment of a patient with a cement embolism of the right heart chambers after vertebroplasty

2021 ◽  
Vol 23 (1) ◽  
pp. 119-123
Author(s):  
R. M. Muratov ◽  
A. G. Khramchenkov ◽  
A. S. Sachkov ◽  
S. I. Babenko ◽  
B. V. Meshchanov
Keyword(s):  
Heart Surgery ◽  
Rare Complication ◽  
Open Heart Surgery ◽  
Thoracic Vertebrae ◽  
Successful Operation ◽  
Right Heart ◽  
Open Operation ◽  
Cement Embolism ◽  
Life Threatening ◽  
The Right

Cement embolism of the right chambers of the heart after vertebral surgery is an extremely rare complication and occurs in 4 % of cases. The strategies for choosing the treatment of this complication are open-heart surgery under conditions of cardiopulmonary bypass, conservative treatment, or endovascular support. In the case of a fatal complication of embolism, such as perforation of the heart with the development of tamponade or life-threatening arrhythmias, the patient is shown an open operation with infrared. According to the literature, only 14 such operations are described, performed to save the patient’s life. We performed a successful operation of embolectomy from the right heart chambers in a 69‑year-old patient who had previously undergone vertebroplasty of the thoracic vertebrae.

scholarly journals Delayed Tension Pneumocephalus following Gunshot Wound to the Head: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Arthur Wang ◽  
Elena Solli ◽  
Nathan Carberry ◽  
Virany Hillard ◽  
Adesh Tandon
Keyword(s):  
Gunshot Wound ◽  
Rare Complication ◽  
Mass Effect ◽  
Neurological Deficits ◽  
Neurosurgical Procedures ◽  
Review Of The Literature ◽  
Increased Intracranial Pressure ◽  
Tension Pneumocephalus ◽  
Postnasal Drip ◽  
The Right

Tension pneumocephalus is a rare complication of head trauma and neurosurgical procedures, amongst other causes. It is defined by the combination of intracranial air, increased intracranial pressure, and mass effect. Although it often presents soon after surgery, it can also rarely present in a delayed fashion. We present a case of delayed tension pneumocephalus, occurring approximately 16 weeks after bifrontal craniectomy for a self-inflicted gunshot wound. Following a month of rhinorrhea, postnasal drip, and cough, the patient presented with a sensation of expansion in the area of the right forehead. As tension pneumocephalus is an emergency that can be fatal, this patient was treated expediently and avoided severe neurological deficits. The case recounted here is important as a demonstrative example that tension pneumocephalus does not always follow a defined course immediately after trauma or neurosurgery but rather can develop insidiously without obvious signs.

scholarly journals Endovascular foreign body removal of a MynxGrip polyethylene glycol (PEG) sealant embolus using a cerebral stent retriever

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Mohammed Shamseldin ◽  
Hendrik Bergert ◽  
Axel Neumeister ◽  
Ralf Puls
Keyword(s):  
Polyethylene Glycol ◽  
Foreign Body ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Stent Retriever ◽  
Closure Device ◽  
Vascular Closure Device ◽  
Stent Retrievers ◽  
The Right

Abstract Background This is a rare case of removing an intra-arterial foreign body represented by MynxGrip polyethylene glycol (PEG) sealant as a rare complication of using the MynxGrip™ Vascular Closure Device (AccessClosure, Inc., Mountain View, CA) using a pRESET stent retriever (Phenox, Bochum, Germany) which is utilized mainly for treatment of endovascular stroke. Case presentation A 60-year-old female patient suffering from intermittent claudication in the right lower limb (stage IIb according to Fontaine) due to a peripheral arterial occlusive disease was presented for an elective revascularization using balloon angioplasty of a short chronic occlusion of the right superficial femoral artery. After a successful revascularization of the right superficial femoral artery using a retrograde femoral access from the left common femoral artery, the patient suffered from an acute limb ischemia in the left foot with distal popliteal embolization with involvement of BTK (below the knee) trifurcation. This is believed to be due to an intra-arterial foreign body embolism of MynxGrip polyethylene glycol sealant as a rare complication of using the MynxGrip™ Vascular Closure Device. Conclusions Stent retrievers have been used previously in removing dislocated coils especially in the cerebral vessels. This case report however proves a high efficacy and safety of using stent retrievers in removing different and rather unusual intra-arterial foreign bodies such as MynxGrip polyethylene glycol sealant.

scholarly journals Ventricular Tachycardia from a Central Line Fracture Fragment Embolus: A Rare Complication of a Commonly Used Procedure—A Case Report and Review of the Relevant Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Saptarshi Biswas ◽  
Patrick McNerney
Keyword(s):  
Ventricular Tachycardia ◽  
Rare Complication ◽  
Relevant Literature ◽  
Gunshot Wounds ◽  
Complete Recovery ◽  
Central Line ◽  
Fracture Fragment ◽  
Retrieval Technique ◽  
The Right

A 22-year-old male admitted with multiple gunshot wounds (GSW) had central line placed initially for hemodynamic monitoring and later for long term antibiotics and total parenteral nutrition (TPN). On postoperative day 4 he presented with bouts of nonsustained ventricular tachycardia; the cause was unknown initially and later attributed to a catheter fragment accidentally severed and lodged in the right heart. Percutaneous retrieval technique was used to successfully extract the catheter fragment and complete recovery was achieved.

scholarly journals A Case study of Dushta Vrana treated with kampilakadi tail Vranabasti”

2018 ◽  
Vol 6 (02) ◽  
Author(s):  
Monali Bhagawat Patil ◽  
Vidya Dharne
Keyword(s):  
Wound Healing ◽  
The Body ◽  
Local Application ◽  
Vascular Insufficiency ◽  
Systemic Factors ◽  
Immune Deficiencies ◽  
Injured Part ◽  
Foul Smell ◽  
Contaminated Wound ◽  
The Right

“The destruction / break / rupture / discontinuity of body tissue / part of body, is called VRANA” A clean wound in a normal body heals earlier with a minimum scar as compared to contaminated wound. Wound healing is mechanism where the body attempts to restore the integrity of the injured part. Several factors affects the normal process of wound healing such as the site of wound, contamination (foreign bodies/bacterial), local factors like vascular insufficiency or previous radiation, systemic factors such as malnutrition, Disease like diabetes mellitus, Immune deficiencies and medications like steroids. Acharya Sushruta mentioned 60 Upakramas for the management of Vrana and local application of kampilakadi tail Vrana Basti is one among them. The local application of VranaBasti is one of the best substitutes for of chronic wound healing & the kampilakadi tail  have better shodhana & ropana effect. A case report of 34 year – old man, who presented with complaints of an open traumatic ulcer on the dorsum of the right foot associated with pain, discharge, slough, foul smell, oedema and discolouration of the skin has been presented here.

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