Citation

Yamanari MGI, Mansur MC, Kay FU, Silverio PR, Jayanthi SK, Funari MB. Radiol. Bras. 2014; 47(2): 128-130.

Affiliation

Chief of Chest Division, Instituto de Radiologia - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), Chief of Imaging Department - Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Copyright

(Copyright © 2014, Colegio Brasileiro de Radiologia)

DOI

10.1590/S0100-39842014000200018

PMID

25741063

Abstract

The effects of a bullet in the body depend on a range of factors: velocity, entrance profile, bullet diameter, path of the bullet inside the body and biological characteristics of the affected organ. A rare and unpredictable complication of firearm injuries is bullet embolism. With only few cases described in the literature, bullet embolism may become a diagnostic challenge for emergency physicians. Venous bullet embolism occurs even more rarely, with the following complications: heart valve dysfunction, endocarditis, septicemia, venous thrombosis, thrombophlebitis, arrhythmias and hypoxemia secondary to arterial pulmonary embolism.

The authors report the case of a patient victim of gunshots, with a very rare complication: venous bullet embolism from the left external iliac vein to the lingular segment of the left pulmonary artery. Diagnosis is made with whole-body radiography or computed tomography. Digital angiography is reserved for supplementary diagnosis or to be used as a therapeutic procedure.

KEYWORDS:

Bullet embolism; Computed tomography; Pulmonary arteriography; Trauma

Language: en

Vernacular Abstract

Relatamos o caso de um paciente vítima de tiros por arma de fogo e com uma rara complicação: embolia venosa de um projétil desde a veia ilíaca externa esquerda até o ramo lingular da artéria pulmonar esquerda. Radiografias de corpo inteiro ou tomografia computadorizada do corpo inteiro devem ser utilizadas. Angiografia digital fica reservada para complementação diagnóstica ou como procedimento terapêutico.