[Bullet embolism in a case of homicide: case report]. 2013

Vladimir Zivković, and Fehim Juković, and Slobodan Nikolić

BACKGROUND Bullet embolism is a special form of embolism, where embolus is either a bullet or its fragment. Bullet penetrates through the injured part of the body into circulation and then travels to a distant part of the body, until it gets blocked in a vessel of the same diameter as the bullet. METHODS We are presenting a case of gunshot injury in a 26-year-old male, found unconscious on the passenger seat, with the gunshot injury of the right hand and hemithorax, who died two hours after admission to hospital. Post-mortem X-ray revealed the presence of a metallic foreign body - a bullet, in the level of the left femoral neck. The autopsy revealed entrance and exit gunshot wounds of the upper third of the right upper arm.There was a second entrance gunshot wound, and the bullet passed through the right hemithorax and the right lung, and then through the intervertebral disc between the eighth and ninth thoracic vertebrae, and also making a complete laceration of the wall of the thoracic aorta, in the right posterior semicircumference. The slightly deformed bullet, caliber 7.65 mm, was found embedded in the lumen of the vessel at the bifurcation of the deep femoral artery from the left femoral artery. CONCLUSIONS Bullet embolism is a rare complication of gunshot wounds. It should be suspected in any gunshot wound victim without an exit wound, or the lack of a missile in the bullet pathway, or if there are premortem signs or symptoms unexpected for the presumed pathway of the bullet, such as distant ischemia or infection. In these cases, some of postmortem imaging techniques should be used to save time in diagnosis, treatment and at autopsy.

UI MeSH Term Description Entries
D008297 Male Males
D004617 Embolism Blocking of a blood vessel by an embolus which can be a blood clot or other undissolved material in the blood stream. Embolus,Embolisms
D005263 Femoral Artery The main artery of the thigh, a continuation of the external iliac artery. Common Femoral Artery,Arteries, Common Femoral,Arteries, Femoral,Artery, Common Femoral,Artery, Femoral,Common Femoral Arteries,Femoral Arteries,Femoral Arteries, Common,Femoral Artery, Common
D005548 Foreign-Body Migration Migration of a foreign body from its original location to some other location in the body. Foreign Body Migration,Foreign-Body Migrations,Migration, Foreign-Body,Migrations, Foreign-Body
D006708 Homicide The killing of one person by another. Murder,Killing,Wrongful Death,Death, Wrongful,Deaths, Wrongful,Homicides,Killings,Murders,Wrongful Deaths
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014948 Wounds, Gunshot Disruption of structural continuity of the body as a result of the discharge of firearms. Gunshot Wound,Gunshot Wounds,Wound, Gunshot
D044709 Forensic Ballistics The science of studying projectiles in motion, ballistics, being applied to law. Ballistics on firearm projectiles, such as bullets, include the study of what happens inside the weapon, during the flight of the projectile, and when the projectile strikes the target, such as body tissue. Ballistics,Ballistics, Wound,Ballistic, Forensic,Ballistics, Forensic,Forensic Ballistic,Wound Ballistics

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