Bullet embolization to the external iliac artery after gunshot injury to the abdominal aorta: a case report
نویسندگان
چکیده
INTRODUCTION Abdominal vascular trauma is fairly common in modern civilian life and is a highly lethal injury. However, if the projectile is small enough, if its energy is diminished when passing through the tissue and if the arterial system is elastic enough, the entry wound into the artery may close without exsanguination and therefore may not be fatal. A projectile captured may even travel downstream until it is arrested by the smaller distal vasculature. The occurrence of this phenomenon is rare and was first described by Trimble in 1968. CASE PRESENTATION Here we present a case of a 29-year-old Albanian man who, due to a gunshot injury to the back, suffered fracture of his twelfth thoracic and first lumbar vertebra, injury to the posterior wall of his abdominal aorta and then bullet embolism to his left external iliac artery. It is interesting that the signs of distal ischemia developed several hours after the exploratory surgery, raising the possibility that the bullet migrated in the interim or that there was a failure to recognize it during the exploratory surgery. CONCLUSION In all cases where there is a gunshot injury to the abdomen or chest without an exit wound and with no projectile in the area, there should be a high index of suspicion for possible bullet embolism, particularly in the presence of the distal ischemia.
منابع مشابه
The Arterial Pattern of Terminal Branch of the Abdominal Aorta in the Male Persian Squirrel (Sciurus Anomalus)
Introduction: The Persian squirrel (Sciurus anomalus) is considered the only well-known species of the family Sciuridae in the Middle East. Since some people keep this squirrel as a domestic pet, their attendance at veterinary clinics is increasing. So far, no study has been conducted on the arterial supply of the pelvic cavity and limb in the squirrel. Hence, this research was performed to fil...
متن کاملPopliteal artery embolism of bullet after abdominal gunshot wound
Bullet embolism to the peripheral arterial system is a rare phenomenon which frequently results in misdiagnosis due to lack of early symptoms. Embolisms can go to either arterial or venous systems with common sites of injury including the left ventricle, pulmonary vein, thoracic and abdominal aorta and peripheral arteries. Herein we present a case of a 19 year old patient with multiple gunshot ...
متن کاملPenetrating aortic injury left untreated for 20 days: a case report
BACKGROUND Penetrating aortic trauma remains one of the most challenging injuries with a high mortality rate if left untreated, or if the surgical treatment is delayed. We present an uncommon case of a late diagnosed abdominal firearm injury, in which the bullet partially penetrated the wall of the aorta, creating a plug that prevented immediate death due to massive bleeding. CASE PRESENTATIO...
متن کاملSuccessful endovascular coiling of a ruptured internal iliac artery aneurysm: a case report
Ruptured internal iliac artery aneurysms (IIAA) are extremely rare, and the repair can be challenging. This case reports described an 83-year-old patient who presented at our Emergency Department with acute abdominal pain based on a ruptured IIAA. He refused open repair and only wanted to be treated as minimally invasive as possible. Therefore endovascular embolization of the IIAA was performed...
متن کاملExternal iliac artery injury secondary to indirect pressure wave effect from gunshot wound
In patients presenting with gunshot wounds, a high clinical suspicion of injury to vasculature and viscera remote from the projectile track is paramount. We present a case of a 17 year old male who sustained a gunshot wound to his abdomen and subsequently developed a right external iliac artery contusion requiring surgery as an indirect effect of the pressure wave from the bullet.
متن کامل