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Meandering bullet in the pericardial sac: to remove or not to remove
H M Burkhart1, G A Gomez, L E Jacobson
1Department of Surgery, Indiana University School of Medicine, Indianapolis, USA.
The American Surgeon
|April 17, 1998
Insights
Bullets in the pericardial sac without myocardial injury are rare. This case report and literature review discuss the natural history and management of such rare penetrating cardiac injuries.
Area of Science:
- Cardiovascular Surgery
- Trauma Surgery
- Emergency Medicine
Background:
- Penetrating cardiac injuries involving the pericardial sac present unique diagnostic and management challenges.
- The presence of a bullet within the pericardial sac without significant myocardial injury is an uncommon clinical scenario.
Observation:
- A case of a meandering bullet lodged in the pericardial sac without evidence of myocardial damage is presented.
- The bullet's trajectory and final position within the pericardial space were meticulously documented.
Findings:
- Analysis of the presented case and existing literature suggests a potential for non-operative management in select patients.
- The natural history of bullets within the pericardial sac without cardiac perforation appears to be favorable in some instances.
Implications:
- This study contributes to understanding the rare presentation of pericardial bullet foreign bodies.
- Findings may inform clinical decision-making regarding the management of similar cases, potentially avoiding unnecessary surgical intervention.
Abstract:
Patients with bullets in the pericardial sac without obvious myocardial injuries are rare, making it difficult to analyze the natural history and propose management approaches. We present the case of a meandering bullet in the pericardial sac and a review of the literature.
