%0 Journal Article
%T Bullet embolization to the external iliac artery after gunshot injury to the abdominal aorta: a case report
%A Luan Jaha
%A Bekim Ademi
%A Vlora Ismaili-Jaha
%A Tatjana Andreevska
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-354
%X Here we present a case of a 29-year-old Albanian man who, due to a gunshot injury to the back, suffered fracture of his twelfth thoracic and first lumbar vertebra, injury to the posterior wall of his abdominal aorta and then bullet embolism to his left external iliac artery. It is interesting that the signs of distal ischemia developed several hours after the exploratory surgery, raising the possibility that the bullet migrated in the interim or that there was a failure to recognize it during the exploratory surgery.In all cases where there is a gunshot injury to the abdomen or chest without an exit wound and with no projectile in the area, there should be a high index of suspicion for possible bullet embolism, particularly in the presence of the distal ischemia.Abdominal vascular trauma is fairly common in modern civilian life and is a highly lethal injury, with overall mortality around 40% in some reported series. The main cause for this high mortality relates to problems transporting injured patients to the hospital fast enough to prevent exsanguination. Furthermore, abdominal vascular injuries are rarely isolated, and other organs are often severely damaged as well.However, bullet penetration of the aorta is not always fatal. If the projectile is small enough and the arterial system elastic enough, the entry wound into the arterial channel may close without exsanguination. A small projectile thus captured will travel within the lumen with the current of blood flow until it is swept far enough to be halted by the diminishing diameter of tile peripheral vasculature. The occurrence of this phenomenon is rare. In 1968, Trimble [1] was the first to summarize the cases published until that time. There were 33 reports, dating back to 1885. He added two additional cases. Two more were added by Cyrus and Klein in 1972 [2], and since then there have been several others [3-14]. In these reports different techniques for treatment were presented, starting with very common me
%U http://www.jmedicalcasereports.com/content/5/1/354