On the other hand, a retained bullet
in a joint can not only lead to mechanical damage and proliferative synovitis but also can cause systemic absorption of lead and lead poisoning.3 These patients can present with the non-specific neurologic, and gastrointestinal symptoms of lead poisoning and these cases can be difficult to diagnose.
The exact location of the retained bullet
prior to migration into the bladder was not clear.
Once, in an effort to compare penetration and retained bullet
weights of three handgun cartridges, I fired JHP's from each into a railroad tie.
fragments (RBFs) are an infrequently reported, but important, cause of lead toxicity; symptoms are often nonspecific and can appear years after suffering a gunshot wound (2,3).
Radiographs revealed a retained bullet
and metallic debris in the right femoral head (Fig.
The retained bullet
weight was 106.8 grains--or 85%--and it penetrated to a depth of 16.25 inches.
Lead toxicity in a 14-year-old female with retained bullet
This situation is unique in that an exploratory procedure may not truly be necessary if concomitant organ injury is absent and the perforation is extraperitoneal, but conservative management with catheter drainage alone does not address the retained bullet
Increased lead absorption and lead poisoning from a retained bullet
. J Okla State Med Assoc 82:63-67 (1989).
A radiograph of the right elbow revealed a retained bullet
within the confines of a well-defined cystic soft tissue lesion, posterior to the distal end of the humerus (Figure 1, arrowheads).
Lead poisoning is a reportable disease in the United States, affecting nearly 700,000 American children between the ages of 6 months and 5 years. The usual source of environmental exposure to lead is paint in old houses that are dilapidated or undergoing renovation Few cases of elevated lead levels from retained bullet
fragments have been reported in the literature.