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[Bullet embolism in the right pulmonary artery]
R Schöpf1, D Lungenschmid, D Hagen
1Radiologische Praxis, Landeck, Tirol.
Aktuelle Radiologie
|October 6, 1998
Summary
A bullet lodged in the pulmonary artery, discovered incidentally on a chest X-ray, led to lobar fibrosis. This case highlights a rare bullet embolism complication.
Area of Science:
- Cardiology
- Radiology
- Pulmonary Medicine
Background:
- Bullet emboli are rare but serious complications of penetrating trauma.
- Vascular entry points can lead to distant embolization, posing diagnostic challenges.
Observation:
- A 74-year-old patient presented for a routine preoperative chest film.
- Incidental finding of a bullet (2 x 0.7 cm) within the middle lobe pulmonary artery.
Findings:
- The bullet originated from a left masseteric region injury during World War II, entering the left jugular vein.
- CT-curved reformations confirmed the bullet's intrapulmonary arterial location.
- Associated finding of lobar fibrosis secondary to focal hypoxemia.
Implications:
- This case underscores the importance of considering remote projectile trajectories in vascular imaging.
- Pulmonary artery bullet emboli can result in significant long-term lung complications.
- Advanced imaging techniques are crucial for diagnosing and localizing intravascular foreign bodies.