Eur J Cardiothorac Surg 2003;23:242
© 2003 Elsevier Science NL
Images in cardio-thoracic surgery |
Distant endoarterial bullet migration following penetrating chest injury
Pier Luigi Filossoa*,
Giovanni Donatia,
Gianni Agacciob,
Maurizio Mancusoa
a Department of Thoracic Surgery, San Giovanni Battista Hospital, University of Turin, Via Genova,3 10126 Torino, Italy
b Department of Cardiac Surgery, San Giovanni Battista Hospital, C.so Dogliotti, 14 10126 Torino, Italy
Received 22 August 2002;
received in revised form 17 September 2002;
accepted 5 November 2002.
* Corresponding author. Tel.: +39-011-633-6635; Fax: +39-011-696-0170
e-mail: pierluigifilosso{at}tiscalinet.it
Key Words: Left haemothorax • Bullet migration • Ultrasonographic examination
A 61-year-old man was referred to us for massive left haemothorax (Fig. 1)
following a penetrating thoracic gunshot wound. The entrance wound was between the scapula and the spine; no exit wound was evident. Left coxofemoral X-ray demonstrated the presence of the retained bullet in the left femoral region (Fig. 2)
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Fig. 2. Left coxofemorax X-ray with the retained bullet in the femoral region. The bullet, located in the left superficial femoral artery, was removed with an arteriotomy.
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An emergency left thoracotomy was performed and a small regular round laceration of the thoracic aorta was detected and closed with primary suture; a pulmonary upper lobe laceration was sutured too. No other endothoracic lesions were observed.
The bullet was detected in the left superficial femoral artery by ultrasonographic examination, and successfully removed with an arteriotomy. The absence of diaphragmatic and abdominal lesions are suggestive of an endoarterial migration of the bullet.
The postoperative course was uneventful and the patient was discharged from the hospital in good general condition.
