Unexplained pellets in heart after shotgun wound through the hip: A case report

Ali Utkan; Bülent Koçer; Batuhan Gencer; Bülent Özkurt

doi:10.28982/josam.641944

Authors

Ali Utkan https://orcid.org/0000-0002-3653-3998
Bülent Koçer https://orcid.org/0000-0002-7344-9859
Batuhan Gencer https://orcid.org/0000-0003-0041-7378
Bülent Özkurt https://orcid.org/0000-0002-6135-1870

DOI:

https://doi.org/10.28982/josam.641944

Keywords:

Shotgun wound, Pellet migration, Foreign body embolism, Chest X-ray

Abstract

The replacement of foreign materials in the human body is rare and the exact mechanism of migration has never been entirely explained. This case was found worth reporting because of the pellets found in the heart of a patient injured by a shotgun through the hip region. The patient was brought to the emergency service because of a hunting rifle injury. Examination revealed numerous entry holes in the gluteal region but there was no sign of injury in the chest or back. On radiographs, there were numerous pellets in the hip and thigh regions. Routine chest X-ray showed four pellets within the mediastinum, probably within the heart, so patient was followed up to prevent probable complications. It should be considered that unexpected complications may be encountered in shotgun injuries due to migration of pellets regardless of the region of injury.

Downloads

Download data is not yet available.

References

Aydın E, Dülgeroğlu TC, Metineren H. Migration of a Kirschner wire to the dorsolateral side of the foot following osteosynthesis of a patella fracture with tension band wiring- a case report. J Med Case Rep. 2016;10:41. Doi: 10.1186/s13256-016-0819-5.

Batın S, Ozan F, Gürbüz K, Uzun E, Kayalı C, Altay T. Migration of a Broken Kirschner Wire after Surgical Treatment of Acromioclavicular Joint Dislocation. Case Rep Surg. 2016;2016:6804670. Doi: 10.1155/2016/6804670.

Kalia A, Khatri K, Singh J, Bansal K, Sagy M. Broken Pieces of Cerclage Wire Lying in Soft Tissue Envelope Around Knee Joint- A Case Report and Review of Literature. J Orthop Case Rep. 2016;6(3):75-7. Doi: 10.13107/jocr.2250-0685.518.

Sharma SK, Sharma SK, Aslam M, Chadha GN. Intra-articular Migration of Broken Patellar Tension Band Wire- A Rare Case. J Orthop Case Rep. 2016;6(5):41-3. Doi: 10.13107/jocr.2250-0685.622.

Tan L, Sun DH, Yu T, Wang L, Zhu D, Li YH. Death Due to Intra-Aortic Migration of Kirschner Wire from the Clavicle- A Case Report and Review of the Literature. Medicine. 2016;95(21):e3741. Doi: 10.1097/MD.0000000000003741.

Leonardi F, Rivera F. Intravascular Migration of a Broken Cerclage Wire into the Left Heart. Orthopedics. 2014;37(10):e932-e935. Doi: 10.3928/01477447-20140924-90.

Karaman I, Kafadar IH, Oner M, Halici M. Intrapelvic pin migration after Salter innominate osteotomy and laparoscopic removal: a case report. J Pediatr Orthop B. 2013;22(6):533–5. Doi: 10.1097/BPB.0b013e32836422a0.

Chen Y, Sun C, Wang J, Li S, Zhao G, Lu Z. Migration of a Metallic Foreign Body into the Heart. J Card Surg. 2015;30(12):891-3. Doi: 10.1111/jocs.12648.

Hussein N, Rigby J, Abid Q. Bullet Embolus to the Right Ventricle Following Shotgun Wound to the Leg. BMJ Case Rep. 2012;14:2012. Doi: 10.1136/bcr-2012-007471.

Gutierrez V, Radice F. Late Bullet Migration into the Knee Joint. Arthroscopy. 2013;19(3):E15. Doi: 10.1053/jars.2003.50065.

Altınbaş Ö, Tanyeli Ö. Surgically managed gunshot injury of the heart; Bullet in the right coronary artery. J Surg Med. 2018;2(2):193-4. Doi: 10.28982/josam.407946.

Lyons FA, Rockwood CA. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am. 1990;72(8):1262–7.

Freund E, Nachman R, Gips H, Hiss J. Migration of a Kirschner wire used in the fixation of a subcapital humeral fracture, causing cardiac tamponade: case report and review of literature. Am J Forensic Med Pathol. 2007;28(2):155–6. Doi: 10.1097/PAF.0b013e31806195a1.

Rich NM, Collins GJ Jr, Andersen CA, McDonald PT, Kozloff L, Ricotta JJ. Missile emboli. J Trauma. 1978;18(4):236–9.

Gschwind CR. The intravenous foreign body: a report of 2 cases. J Hand Surg Am. 2002;27(2):350-4.