Intra-myocardial Bullet causing heart block in a patient with multiple gunshot wounds: Case Report

 

Authors: Odhiambo W.A. 1 BDS, MDS (OMFS), Guthua S.W. 1 BDS, MMED SC, DOMS, FIAOMS, FCS, Munene J. 2, MBChB,

 MMed, Kariuki C. 3, MBChB, Mmed, FRCP Thanga P.W. 3 MBChB. Affiliations: 1 Department of Oral and Maxillofacial Surgery, University of Nairobi, 2 Kenyatta National Hospital, Nairobi, 3 The Nairobi Hospital. Corresponding Author; Dr. Walter Odhiambo, Department of Oral and Maxillofacial surgery, School of Dental Sciences, College of Health Sciences. P.O. BOX 19676, KNH, NAIROBI Tel 254-20-3873398 Cell 254-722-518616. E-mail: walter.odhiambo@uonbi.ac.ke

 

Summary

Elective removal of intra-myocardial bullet remains a controversial subject. A non-operative approach has been recommended as appropriate for a stable asymptomatic patient. In the presence of complications such as bleeding, perforation leading to cardiac tamponade, thrombus formation, embolization, rhythm disturbances and infections, surgical removal may be advised. We present a patient who survived multiple gunshot wounds with a bullet lodged in the wall of the left ventricle of the heart. Details of the injuries sustained, operative removal of the bullet and the challenges that ensued are illustrated.

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