# Missile embolism from pulmonary vein to left ventricle: report of a case

## TL;DR

A 7-year-old boy survived a rare case where a bullet traveled from his chest wound into his heart and was successfully removed.

## Contribution

This paper reports a rare case of bullet embolism from the pulmonary vein to the left ventricle following chest trauma in a child.

## Key findings

- A bullet was found in the left mediastinum following chest trauma in a 7-year-old boy.
- The foreign body was successfully removed via surgery without causing long-term heart complications.
- After six months, no infection or valve damage was observed.

## Abstract

Missile embolization is rare in penetrating trauma, occurring in 0.3% of cases. Bullet embolism into the left ventricle is less frequent, with few instances described in the literature. This paper describes an instance of left ventricular bullet embolism from the pulmonary venous system following gunshot chest trauma. A 7-year-old boy sustained a gunshot wound to his chest during an assault accident. Despite thoracic pain, he remained conscious and exhibited vital signs. A CXR and CT scan revealed a bullet in the left mediastinum. A left thoracotomy was performed to remove blood and clots from the pericardium. The patient was sent to a tertiary referral hospital for further investigation. The patient underwent elective surgery to remove the foreign body from inside the heart. The procedure involved a partial thymectomy and pericardial opening, and the patient was released from medical care after 14 days. After 6 months, there were no signs or symptoms of cardiothoracic infection or evidence of mitral valve regurgitation in echocardiography.