Peripheral Venous Bullet Embolization To The Heart – A Case Study

A bullet embolism is a rare complication following penetrating gunshot injury which can present challenges in diagnosis and management. If the projectile has been unsuccessfully removed or remains left in situ, there is a risk that the missile may have gained access to the vascular system from where the flow of blood migrates the foreign body to any number of large vascular beds. Arterial embolization is more common and is often accompanied with symptoms associated with end-organ damage and peripheral ischemia. Venous embolization is less common with few, or no symptoms reported, unless vascular injury, pulmonary embolism or oedema related venous flow obstruction is experienced which may require urgent attention. We present the incidental findings of a bullet within the right ventricle following a gunshot injury to the right upper thigh eleven years prior. To our knowledge, this is the first reported incidence identified in the United Kingdom.