A rare case of migration of ballistic projectile from left to right main bronchus
A foreign body in the bronchus due to a ballistic projectile is very uncommon. A 45-year-old man presented to the hospital after being accidentally shot. The initial radiographic assessment found a bullet in his left thoracic cavity. With the help of an X-ray, an urgent left posterolateral thoracotomy was conducted, but no foreign body was found. The foreign body had migrated to the contralateral chest cavity, as determined by the C-arm. On the following day, a thorax computed tomography scan was conducted, and it was discovered that the foreign body had already migrated to the right lower bronchus. A right thoracotomy was then performed to remove the foreign body. He was moved to the intensive care unit and discharged with a stable condition. In conclusion, migration of a foreign body in the bronchus is rare. A thorough strategy is required to prevent the object from migrating even further.
Shields TW, LoCicero J, Reed CE, Feins RH, editors. General thoracic surgery. 7th ed. Philadelphia, Lippincott Williams & Wilkins; 2009.
Wiseman NE. The diagnosis of foreign body aspiration in childhood. J Pediatr Surg. 1984;19(5):531-5. https://doi.org/10.1016/S0022-3468(84)80097-4
O'Connor JV, Haan JM, Wright JL. Spent bullet in the bronchus. Am Surg. 2006;72(4):345-6. https://doi.org/10.1177/000313480607200414
Swanson KL, Edell ES. Tracheobronchial foreign bodies. Chest Surg Clin N Am. 2001;11(4):861-72.
Rhee PM, Moore EE, Joseph B, Tang A, Pandit V, Vercruysse G. Gunshot wounds: a review of ballistics, bullets, weapons, and myths. J Trauma Acute Care Surg. 2016;80(6):853-67. https://doi.org/10.1097/TA.0000000000001037
Holmen LB. Gunshot wounds to the chest [Internet]. Universitetet i Oslo; 2013 [cited 2021 Feb 9]. Available from: https://www.duo.uio.no/bitstream/handle/10852/38984/Prosjektoppgave---skuddskader-i-brystet.pdf?sequence=1.
Inci I, Ozçelik C, Taçyildiz I, Nizam O, Eren N, Ozgen G. Penetrating chest injuries: unusually high incidence of high-velocity gunshot wounds in civilian practice. World J Surg. 1998;22(5):438-42. https://doi.org/10.1007/s002689900412
O'Connor JV, Adamski J. The diagnosis and treatment of non-cardiac thoracic trauma. J R Army Med Corps. 2010;156(1):5-14. https://doi.org/10.1136/jramc-156-01-02
Patterson GA, Cooper JD, Deslauriers J, Lerut AEMR, Luketich JD, Rice TW, editors. Pearson's thoracic and esophageal surgery, 3rd ed. Philadelphia: Churchill Livingstone; 2008.
Patrini D, Lawrence D, Lampridis S, Minervini F, Giorgi L, Palermo R, et al. The role of a multidisciplinary team in chest wall trauma management. J Vis Surg. 2020;6:19. https://doi.org/10.21037/jovs.2019.12.01
Babatasi G, Massetti M, Bhoyroo S, Le Page O, Khayat A. Pulmonary artery bullet injury following thoracic gunshot wound. Eur J Cardiothorac Surg. 1999;15(1):87-90. https://doi.org/10.1016/S1010-7940(98)00264-4
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