Citation

Wallace KL, Slovis CM. Ann. Emerg. Med. 1987; 16(1): 102-104.

Copyright

(Copyright © 1987, American College of Emergency Physicians, Publisher Elsevier Publishing)

DOI

unavailable

PMID

3800059

Abstract

The case of a patient with a hepatic vein bullet embolus complicating a left ventricular gunshot injury is described. The patient presented hypotensive with a left midaxillary entrance wound. Initial radiographs showed a bullet fragment below the right hemidiaphragm. Emergency open thoracotomy was performed with release of a tense pericardial effusion and repair of a left ventricular penetrating wound. Surgical exploration failed to reveal direct penetrating injury to the diaphragm or abdominal viscera. After a hepatic venogram localized the bullet fragment in a branch of the right lobe hepatic vein, a periscopically directed catheter extraction of the fragment was successfully performed. A discussion of missile embolization, its pathology, clinical presentation, diagnosis, and management is presented.

Language: en