Bullet emboli

Case contributed by Jayanth Keshavamurthy , 22 Sep 2017
Diagnosis certain
Changed by Henry Knipe, 24 Sep 2017
Hidden edits. Some edits not affecting the appearance of this case have been suppressed.

Updates to Case Attributes

Presentation was changed:
ICU chest radio graph, what is round object over the heart?radiograph.
Age changed from 69 to 70 years.
Body was changed:

Actually, on the CT the resident thought the linear artefact as a retained pacemaker wire.

A metallic density is identified within the inferior aspect of the right atrium, which is favored to represent a small segment of retained pacer lead. Results have been communicated by radiology to the primary team regarding this small fragment of a retained pacer lead.

So doIt is important not forget to seereview the scout.

CT obtained in a beating heart and see how the computer generates a line on sagittal and coronal images and will fool you.

  • -<p>Actually on the CT the resident thought the linear artefact as a retained pacemaker wire.</p><p>A metallic density is identified within the inferior aspect of the right atrium, which is favored to represent a small segment of retained pacer lead. Results have been communicated by radiology to the primary team regarding this small fragment of a retained pacer lead.</p><p>So do not forget to see the scout.</p><p>CT obtained in a beating heart and see how the computer generates a line on sagittal and coronal images and will fool you.<br> </p><p> </p>
  • +<p>Actually, on the CT the resident thought the linear artefact as a retained pacemaker wire.</p><p>A metallic density is identified within the inferior aspect of the right atrium, which is favored to represent a small segment of retained pacer lead. Results have been communicated by radiology to the primary team regarding this small fragment of a retained pacer lead.</p><p>It is important not forget to review the scout.</p><p>CT obtained in a beating heart and see how the computer generates a line on sagittal and coronal images and will fool you.</p>

Updates to Study Attributes

Caption was removed:
What is overlying the heart?
Findings was changed:

Endotracheal tube is demonstrated 5 cm above the carina. A left internal jugular central line is demonstrated with the tip at the SVC.. A right-sided PICC line is demonstrated with the tip at thecavoatrial junction. Heart is normal size. Thoracic aorta is partially calcified.Lungs are clear with normal vascularity and inflation.A small metallic birdshot like radiopaque foreign body projects inat the Rightright atrium IVC-IVC junction.

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