# Venovenous Extracorporeal Membrane Oxygenation Usage Following Bullet Embolism to the Pulmonary Artery

## TL;DR

A patient with a bullet in the pulmonary artery developed severe lung failure, which was successfully treated with a special life-support system.

## Contribution

Demonstrates the viability of venovenous extracorporeal membrane oxygenation in managing respiratory failure after bullet embolism to the pulmonary artery.

## Key findings

- Venovenous extracorporeal membrane oxygenation successfully managed severe acute respiratory distress syndrome in a patient with a bullet embolus.
- Surgical embolectomy combined with extracorporeal membrane oxygenation can be a viable treatment option for selected patients.
- Bullet embolism to the pulmonary artery is rare but can lead to life-threatening complications requiring advanced interventions.

## Abstract

Background: Pulmonary artery embolus is a rare complication following gunshot wounds that creates a unique and serious challenge for trauma surgeons. While the majority of bullets that embolize through the vascular system end in the peripheral circulation, approximately one-third enter the central venous circulation.

Case Report: We present the case of a bullet embolus to the left pulmonary artery following gunshot wounds to the right chest and the abdomen, with the abdominal ballistic traversing the liver before entering the vena cava and embolizing. The patient's course was complicated by the development of severe acute respiratory distress syndrome that was successfully managed by venovenous extracorporeal membrane oxygenation.

Conclusion: Venovenous extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome after bullet embolization to the pulmonary tree and surgical embolectomy is a viable option in appropriately selected patients.