Bullet Embolism after Gunshot Injury: A Case Report

  • Adlan Olsun
  • C. Duzyol
  • A. K. Gur
  • M. Kaplan
  • S. Sahin
  • R. Tosun


We describe a case of gunshot injury presenting with cardiac tamponade in which a dummy bullet advanced through the aorta and caused embolization in the right renal interlobar artery after passing above the sternoclavicular joint and penetrating into the aorta. Emergency surgery with cardiopulmonary bypass was performed to repair the cardiac tamponade and aortic injury. Postoperatively, a direct abdominal x ray revealed a bullet image, confirmed by an ultrasonography examination that demonstrated the presence of a metal object in the right renal pelvis. The bullet was considered to have reached the kidney via an arterial route and to cause embolization in the distal bed. The procedure was successful, and the patient was discharged on postoperative day 8. In gunshot injuries, if all entrance points are not paired with exit points, the possibility of an organ or extremity embolism caused by the presence of a bullet or shrapnel fragments in circulation should be borne in mind, although such occurrences are rare.


Barret NR. 1960. Foreign bodies in the cardiovascular system. Br J Surg 37:416-45.\nBerkan O, Gunay I. 2002. An unusual case of birdshot embolism. Circ J 66:707-8.\nCorbett H, Paulsen EK, Smith RS, Carman GC. 2003. Paradoxical bullet embolus from the vena cava. J Trauma 55:979-81.\nHabdank K, Nolan RL. 2003. Gunshot wound to the thorax with bullet embolization to the external carotid artery. J Thorac Imaging 18:42-4.\nJones DR, Guy JS, Mill MR, Baker CC. 1999. Retrograde arterial bullet embolus to the coronary artery. J Trauma 46:1135-6.\nGrewal KS, Sintek CF, Jorgensen MB. 1997. Bullet embolism to the heart. Am Heart J 133:468-70.\nMattox KL, Beal AC Jr, Ennix CL, DeBakey ME. 1979. Intravasculer migratory bullets. Am J Surg 137:192-5.\nReil TD, Dorafshar AH, Lane JS, Dong P, Cryer HG, Ahn SS. 2005. Gunshot wound to the left ventricle with bullet embolization to the descending aorta: combined endovascular and surgical management. J Trauma 59:1012-7.\nRich NM, Collins GJ Jr, Andersen CA, McDonald PT, Kozloff L, Ricotta JJ. 1978. Missile emboli. J Trauma 18:236-9.\n
How to Cite
Olsun, A., Duzyol, C., Gur, A., Kaplan, M., Sahin, S., & Tosun, R. (2008). Bullet Embolism after Gunshot Injury: A Case Report. The Heart Surgery Forum, 11(3), E193-E194. https://doi.org/10.1532/HSF98.20081031

Most read articles by the same author(s)