Open AccessThe Curious Case of Retained Bullets - Asymptomatic Gunshot Wounds to the Heart with Delayed Presentation and Management Strategies
Author(s) -
Aabha Divya,
Niti Dalal,
Mona Swain,
Juhi Baktavar
Publication year - 2021
Publication title -
journal of evidence based medicine and healthcare
Language(s) - English
Resource type - Journals
eISSN - 2349-2570
pISSN - 2349-2562
DOI - 10.18410/jebmh/2021/252
Subject(s) - medicine , intracardiac injection , presentation (obstetrics) , asymptomatic , surgery , great vessels , gunshot injury , thorax (insect anatomy) , thoracic trauma , penetrating wounds , case presentation , foreign body , blunt , anatomy
Penetrating trauma to the thorax involving the heart is usually fatal. Discovery and management of intrathoracic missiles especially in the close vicinity of the heart is a major challenge. Retained intracardiac missiles are exceptionally unusual, and there are 322 reported cases over 60 years, from 1940 to 2009.1 We present two patients who presented with penetrating gunshot wounds to the chest with retained intracardiac bullets. The management of hemodynamically stable patients with retained intrapericardial foreign body remains controversial. Management options of thoracic firearm injuries are based on patient stability, course and location of the missile. We report our experience of two patients with delayed presentation of a retained intrapericardial bullet from firearm injuries. In this paper, we discuss the management strategies of such injuries in light of the available literature and summarize our clinical experience.