Projectile Embolism From a Firearm Injury: A Case Report

Mateo Zuluaga Gomez, Daniela Giraldo Campiño, Daniel González Arroyave, Robinson A. Orjuela Correa, Manuela Bedoya Ortiz, Carlos M Ardila

Producción científica: Contribución a una publicación especializadaArtículo

Resumen

Projectile embolism resulting from firearm injuries is a rare but highly lethal complication when not
diagnosed early. This report presents a case of projectile embolism from a firearm injury with an unusual entry site, the cerebral venous circulation, which subsequently migrates to the pulmonary circulation with a fatal outcome. A 24-year-old male patient was admitted to a high-complexity hospital due to a gunshot wound. A plain skull computed tomography (CT) revealed a left laminar subdural hematoma and traumatic subarachnoid hemorrhage with multiple metallic fragments embedded in the skull, some penetrating the galeal sinus, with perilesional bleeding. Contrast-enhanced chest tomography showed non-thrombotic embolism of metallic fragments in the pulmonary artery for the apical segment of the left upper lobe and right intraventricular regions. Transthoracic echocardiography revealed a hyperechoic image of 3 mm in the subvalvular apparatus toward the interventricular septum. Subsequently, the patient experienced neurological deterioration with signs of cerebral edema and parieto-occipital epidural hematomas with metallic fragments and projectiles. Measures to counteract cerebral edema were initiated. Later, the patient
developed mydriasis, the absence of brainstem reflexes, and experienced cardiac arrest. This report
delineates a case of projectile embolism, highlighting a distinctive aspect characterized by an unusual entry point.
Idioma originalEspañol (Colombia)
Volumen16
N.º1
Publicación especializadaCureus
EstadoPublicada - 25 ene. 2024
Publicado de forma externa

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