For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
Inviting an author to review:
Statin-specific inhibition of Rab-GTPase regulates cPKC-mediated IKs internalization
Find an author and click ‘Invite to review selected article’ near their name.
Search for authorsSearch for similar articles
3
views
15
references
 Top references
cited by
2
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      569
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Surgical Management of a Bullet Embolism to the Pulmonary Artery

      case-report
      Author(s): 1 , 2 , , 2
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: pulmonary embolism, bullet embolism, pulmonary artery, thoracotomy

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Bullet embolism is a rare but potentially serious complication of a gunshot wound. This case report describes a 26-year-old male who presented with a gunshot to the lower back. Diagnostics revealed a migrating bullet that became lodged in the left pulmonary artery. After two unsuccessful attempts at endoscopic removal, the decision was made by the multidisciplinary team to retrieve the bullet surgically. The patient recovered well postoperatively. Four- and eight-month follow-up in the emergency department revealed no significant postoperative complications. Bullet embolism should be suspected when radiographs reveal a migrating projectile. Treatment options include conservative management, endoscopic bullet retrieval, and surgical removal. No guidelines for the management of a bullet embolism exist. Management should be based on the patient's clinical status and comorbidities, facility resources, and perceived risk of undergoing surgical retrieval of the bullet.

          Related collections

          Most cited references15

          • Record: found
          • Abstract: found
          • Article: not found

          Foreign bodies.

          Tim B. Hunter, Mihra Taljanovic (2015)
          Foreign bodies are uncommon, but they are important and interesting. Foreign bodies may be ingested, inserted into a body cavity, or deposited into the body by a traumatic or iatrogenic injury. Most ingested foreign bodies pass through the gastrointestinal tract without a problem. Most foreign bodies inserted into a body cavity cause only minor mucosal injury. However, ingested or inserted foreign bodies may cause bowel obstruction or perforation; lead to severe hemorrhage, abscess formation, or septicemia; or undergo distant embolization. Motor vehicle accidents and bullet wounds are common causes of traumatic foreign bodies. Metallic objects, except aluminum, are opaque, and most animal bones and all glass foreign bodies are opaque on radiographs. Most plastic and wooden foreign bodies (cactus thorns, splinters) and most fish bones are not opaque on radiographs. All patients should be thoroughly screened for foreign bodies before undergoing a magnetic resonance imaging study.
          Article 0 comments Cited 56 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Nonthrombotic pulmonary embolism.

            P Jorens, Egbert van Nes, P Parizel … (2009)
            Nonthrombotic pulmonary embolism (NTPE) is defined as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. The purpose of this article is to describe the clinical signs, pathogenesis, diagnosis and treatment of the different NTPE subtypes. The complex and diverse pathogenesis of different subtypes of emboli is subject to continuing speculation and is certainly far more complex than "simple" mechanical obstruction after embolisation of vascular thrombi. Nonthrombotic emboli may also lead to a severe inflammatory reaction both in the systemic and pulmonary circulation, as well as in the lung. NTPE presents a formidable diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations such as acute respiratory distress syndrome to signs observed late in the disease course. Pathological observations play a key role in the exact diagnosis, and sometimes carefully aspirated blood from the pulmonary artery or specific staining of cells recovered from bronchoalveolar lavage fluid may be helpful. Frequently, lung biopsies revealing severe granulomatous reaction or unfortunate post-mortem pathological investigations of pulmonary tissue are necessary to confirm the diagnosis. Here, we also aim to familiarise the reader with the atypical radiological features of NTPE. Thin-section computed tomography of the lungs showing peculiar radiographic findings, such as a feeding vessel, the so-called tree-in-bud pattern or the appearance of micronodules distributed at the termination of bronchovascular bundles, may be observed in certain forms of NTPE. Increased awareness of NTPE as an underestimated cause of acute and chronic embolism, which may result in acute and chronic pulmonary hypertension, is needed. Despite the fact that detailed descriptions of several forms of NTPE have existed for nearly 100 years, well-designed trials have never been performed to evaluate therapy in the different subsets of these patients.
            Article 0 comments Cited 41 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Intravascular migratory bullets.

              C Ennix, K Mattox, M DeBakey … (1979)
              The estimated course of a penetrating missile provides some clues to planning intraoperative priorities and management. However, missiles which become intravascular emboli present diagnostic and therapeutic dilemmas. Twenty-eight patients have been seen with bullet emboli. Five patients had emboli to the lungs, two of which were removed. Two large bullets embolized from a right heart injury down the inferior vena cava, one to a hepatic vein and one to the right renal vein. Fourteen patients had arterial bullet emboli, four originating in the heart, four in the thoracic aorta, and six in the abdominal aorta. Two patients died, one of cerebral infarction secondary to bullet embolus to the right carotid artery and one of an unrecognized traumatic intracardiac defect. Complications were secondary to associated injuries rather than a result of removal of bullet emboli.
              Article 0 comments Cited 25 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 15 May 2020
                Publication date (Electronic, collection): May 2020
                Volume: 12
                Issue: 5
                Electronic Location Identifier: e8138
                Affiliations
                [1 ] Acute Care Surgery, California Hospital Medical Center, Los Angeles, USA
                [2 ] Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, USA
                Author notes
                Article
                DOI: 10.7759/cureus.8138
                PMC ID: 7294874
                PubMed ID: 32550058
                SO-VID: 04e879ef-0283-4e86-9446-4ab604ace475
                Copyright © Copyright © 2020, Kovalev et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 1 May 2020
                Date accepted : 15 May 2020
                Categories
                Subject: Emergency Medicine
                Subject: General Surgery
                Subject: Trauma

                Keywords: pulmonary embolism,bullet embolism,pulmonary artery,thoracotomy
                Data availability:
                Keywords: pulmonary embolism, bullet embolism, pulmonary artery, thoracotomy

                Comments

                Comment on this article

                scite_

                Similar content569

                See all similar

                Cited by2

                See all cited by

                Most referenced authors148

                See all reference authors