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Revista Colombiana de Cirugía
versão impressa ISSN 2011-7582versão On-line ISSN 2619-6107
Resumo
ZULUAGA, Mateo; ESTRADA, Andrés Felipe; ROJAS, María Claudia e URIBE, María Claudia. Pulmonary projectile embolism by firearm: A case report. rev. colomb. cir. [online]. 2020, vol.35, n.3, pp.514-519. Epub 09-Fev-2021. ISSN 2011-7582. https://doi.org/10.30944/20117582.731.
Introduction:
Gunshot wound pulmonary embolism is potentially fatal and a rare complication that can occur in emergency departments. In recent years, there has been a higher incidence of civil social violence (85%) than for wars (15%). The main symptoms of patients are chest pain, dyspnoea and hemoptisis from vascular erosion and associated pulmonary infarction.
Clinical case:
We present a case of an 18-year-old patient who was admitted for multiple projectile wounds by firearm, one of them with a projectile lodged in the pulmonary artery of the right lower lobe and acute pulmonary embolism in the arterial branches distal to the projectile. Conservative management was decided, with adequate evolution.
Discussion:
The symptomatology of this condition depends on the location, associated thrombosis, ischemia phenomena and hemorrhagic complications. Complications of a fire projectile lodged in a pulmonary artery include ischemia, thrombosis, pseudoaneurysms, bleeding, pleural effusion, vascular insufficiency, and endocarditis. Most patients must undergo surgery when the projectile is housed in the main pulmonary arteries or lobar, when located in the segmental and subsegmental arteries tend to have fistulas with bronchi and compensatory vasospasm, which would allow conservative management.
Palavras-chave : vascular system injuries; wounds, gunshot; embolism; pulmonary embolism; conservative treatment.