title: Asymptomatic gunshot wound to the heart with retained intracardiac pellet.
abstract: A 20-year-old man was transferred to our institution with multiple penetrating thoracoabdominal wounds from a shotgun. Imaging revealed several retained shotgun pellets, 1 of which appeared to be located in the left atrium. He was asymptomatic from a cardiac standpoint and was first taken to the operating room to manage his multiple abdominal injuries. Neither an intraoperative echocardiogram nor a formal postoperative echocardiogram definitively determined pellet location (myocardium versus chamber). Because of concerns for pellet embolus from left atrial positioning, the patient was returned to the operating room. After placing the patient on cardiopulmonary bypass, the pellet was identified within the wall of the left atrium and was successfully removed without complication.
authors.affiliation: Department of Surgery, University of California, San Francisco-Fresno, Fresno, California. Electronic address: emills@fresno.ucsf.edu.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Mills
authors.affiliation: Department of Surgery, Community Regional Medical Center, Fresno, California.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Birnbaum
authors.affiliation: Department of Surgery, University of California, San Francisco-Fresno, Fresno, California.
authors.forename: James W
authors.initials: JW
authors.lastname: Davis
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods; D005389:Firearms; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000601:surgery; D006325:Heart Atria / Q000293:injuries / Q000601:surgery; D006335:Heart Injuries / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007813:Laparotomy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D013898:Thoracic Injuries / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: 18