Case report: wandering intravascular bullet with aortic pseudoaneurysm

Area of Science:

• Trauma surgery
• Vascular surgery
• Diagnostic imaging

Background:

• Gunshot wounds can cause complex vascular injuries.
• Abdominal trauma requires prompt and accurate diagnosis.
• Delayed diagnosis of vascular injury can lead to severe complications.

Observation:

• A 26-year-old male sustained a gunshot wound to the left flank without an exit wound.
• Imaging studies included plain abdominal film, computed tomography (CT), and angiography.
• The patient presented with an abdominal aortic pseudoaneurysm and contrast extravasation into the retroperitoneum.

Findings:

• Computed tomography (CT) demonstrated the abdominal aortic pseudoaneurysm and contrast extravasation.
• The bullet was found to have embolized to the left iliac artery.
• Angiography was crucial for definitive localization of the bullet, complementing CT findings.

Implications:

• Early diagnosis and management of traumatic vascular injuries are critical.
• Multi-modal imaging, including CT and angiography, is essential for complex trauma cases.
• Prompt intervention can prevent life-threatening hemorrhage and improve patient outcomes.