Bullet embolism: An evaluative review to achieve an early diagnosis and an adecuate management
Keywords:
Embolism, Fire gun, Imagenology, Penetrating trauma, BallsiticAbstract
Bullet embolism (be) is a rare entity that can have life-threatening consequences. Due to its low frequency and
its lack of symptoms, the diagnosis is often omitted. The embolism can be arterial, venous or paradoxical. For
embolism to take place, ballistics must be special and meet certain requirements. Imaging studies are essential
to reach the diagnosis. The therapy must be individualized according to the type of embolus and the associated
symptomatology. The gold standard is thoracotomy, but in recent years the intravascular approach has come to be
useful to decrease the mortality rate due to be. In this article we review the behavior of be, the clinical picture, and
the diagnostic and therapeutic approaches of the multiple case reports of this entity.
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Huang, J., Pandey, V., Shah, R et al. Popliteal Artery Embolism of
Bullet after Abdominal Gunshot Wound. Radiol. Case Rep., 2016; 11:
-286.
Yoon, B., Grasso, S., & Hofmann, L. J. Management of Bullet Emboli
to the Heart and Great Vessels. Mil. Med., 2018; 183: e307-e315.
https://doi.org/10.1093/milmed/usx191
Rich, N. M., Collins, G. J., Jr., Andersen, C. A., McDonald, P. T., Kozloff,
L., & Ricotta, J. J. Missile Emboli. J. Trauma, 1978; 18: 236-239.
doi: 10.1097/00005373-197804000-00002.
Biswas, S., Cadot, H., & Abrol, S. Gunshot Wound of the Thoracic
Aorta with Right Popliteal Artery Embolization: A Case Report of
Bullet Embolism with Review of Relevant Literature. Case Rep. Emerg.
Med., 2013; 198-617. doi: 10.1155/2013/198617.
Yamanari, M. G., Mansur, M. C., Kay, F. U., Silverio, P. R., Jayanthi,
S. K., & Funari, M. B. Bullet Embolism of Pulmonary Artery: A
Case Report. Radiol. Bras., 2014; 47: 128-130. doi: 10.1590/S0100-
Schroeder, M. E., Pryor, H. I., Chun, A. K., Rahbar, R., Arora, S.,
& Vaziri, K. Retrograde Migration and Endovascular Retrieval of
a Venous Bullet Embolus. J. Vasc. Surg., 2011; 53: 1113-1115. doi:
1016/j.jvs.2010.11.046.
Slobodan, S., Slobodan, N., & Djordje, A. Popliteal Artery Bullet
Embolism in a Case of Homicide: A Case Report and Review of the
Tangible Literature. For. Sci. Int., 2004; 139: 27-33. doi: 10.1016/j.
forsciint.2003.09.014.
Patel, K. R., Cortés, L. E., Semel, L., Sharma, P. V., & Clauss, R. H.
Bullet Embolism. J. Cardiovasc. Surg., 1989; 30: 584-590.
Michelassi, F., Pietrabissa, A., Ferrari, M., Mosca, F., Vargish, T., &
Moosa, H. H. Bullet Emboli to the Systemic and Venous Circulation.
Surgery, 1990; 107: 239-245.
Bertoldo, U., Enrichens, F., Comba, A., Ghiselli, G., Vaccarisi, S., &
Ferraris, M. Retrograde Venous Bullet Embolism: A Rare Occurrence-
Case Report and Literature Review. J. Trauma, 2004; 57: 187-192. doi:
1097/01.ta.0000135490.10227.5c.
Keele, K. L., Gilbert, P. M., Aquisto T. M., Lichtenberg, R., Field,
T. C., & Lee, B. K. Bullet Embolus to the Thoracic Aorta with Successful
Endovascular Snare Retrieval. J. Vasc. Interv. Radiol., 2010; 21:
-158. doi: 10.1016/j.jvir.2009.09.007.
Shannon, J. J., Jr., Vo, N. M., Stanton, P. E., Jr., & Dimler, M. Peripheral
Arterial Missile Embolization: A Case Report and 22-year
Literature Review. J. Vasc. Surg., 1987; 5: 773-778.
Kase, C. S., White, R. L., Vinson, T. L., & Eichelberger, R. P. Shotgun
Pellet Embolus to the Middle Cerebral Artery. Neurology, 1981; 31:
-461. doi: 10.1212/wnl.31.4.458.
Schurr, M., McCord, S., & Croce, M. Paradoxical Bullet Embolism:
Case Report and Literature Review. J. Trauma, 1996; 40: 1034-1036.
doi: 10.1097/00005373-199606000-00034.
Miller, K. R., Benns, M. V., Sciarretta, J. D., Harbrecht, B. G., Ross,
C. B., Franklin, G. A., & Smith, J. W. The Evolving Management of
Venous Bullet Emboli: A Case Series and Literature Review. Injury,
; 42(5): 441-446. doi: 10.1016/j.injury.2010.08.006.
Shannon, F. L., McCroskey, B. L., Moore, E. E., & Moore, F. A. Venous
Bullet Embolism: Rationale for Mandatory Extraction. J. Trauma,
; 27: 1118-1122.
Symbas, P. N., Vlasis-Hale, S. E., Picone, A. L., & Hatcher, C. R.,
Jr. Missiles in the Heart. Ann. Thorac. Surg., 1989; 48: 192-194. doi:
1016/0003-4975(89)90066-0.
Huang, J., Pandey, V., Shah, R., Yedavalli, V., Joshi, A., Stimpson, R.,
Keldahl, M., & Zuiderveld, L. Popliteal Artery Embolism of Bullet after
Abdominal Gunshot Wound. Radiol. Case Rep., 2016; 11: 282-286.
doi: 10.1016/j.radcr.2016.04.011.
Amsel, B. J., Van der Mast, M., De Bock, L., Van Haasen, R., & Beeckman,
C. The Importance of Two-dimensional Echocardiography in
the Location of a Bullet Embolus to the Right Ventricle. Ann. Thorac.
Surg., 1988; 46: 102-103. doi: 10.1016/s0003-4975(10)65865-1.
Alan-Elison, R. M., Díaz-Elizondo, J. A., Segura-Marín, H., López-
Garnica, D., & Treviño-Garza, F. J. Surgical Management of Late
Bullet Embolization from the Abdomen to the Right Ventricle: Case
Report. Int. J. Surg. Case Rep., 2017; 39: 317-320. doi: 10.1016/j.
ijscr.2017.08.049.
Elsisi, I. F. H. A., & Kidambi, A. A Shot to the Heart: A Rare Case
of Cardiac Embolization. Echo Res. Pract., 2018; 5: K19-K21. doi:
1530/ERP-17-0073.
Mandal, A. K., & Oparah, S. S. Unusually Low Mortality of Penetrating
Wounds of the Chest. Twelve Years’ Experience. J. Thorac.
Cardiovasc. Surg., 1989; 97: 119-125.
Mojtahedi, A., Contractor, S., & Kisza, P. S. Endovascular Approach
for Management of Bullet Embolization to the Heart. Vasc. Endovasc.
Surg., 2018; 52: 295-298. doi: 10.1177/1538574418760415.
Zahid, I., Rahim Khan, H. A., Irfan, O. et al. Retrograde Bullet
Migration from Inferior Vena Cava into Right Common Iliac Vein
Following Gunshot: A Case Report. J. Pak. Med. Assoc., 2016; 66:
-1675.
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