Migration of a piece of shrapnel: femoral vein to superior vena cava-azygous junction

• Published in: European journal of cardio-thoracic surgery Vol. 42; no. 3; pp. 584 - 586
• Main Authors: Koirala, Bhagawan, Shrestha, Kajan Raj, Thapa, Bibhusal, Sayami, Prakash
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2012
• Subjects: Adult; Azygos Vein - diagnostic imaging; Azygos Vein - surgery; Biological and medical sciences; Cardiology. Vascular system; Femoral Vein - diagnostic imaging; Follow-Up Studies; Foreign Bodies - diagnostic imaging; Foreign Bodies - physiopathology; Foreign Bodies - surgery; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - surgery; Heart Atria - diagnostic imaging; Humans; Leg Injuries - complications; Leg Injuries - diagnosis; Male; Medical sciences; Metals; Pneumology; Radiography, Thoracic - methods; Rare Diseases; Risk Assessment; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tomography, X-Ray Computed - methods; Treatment Outcome; Vascular Surgical Procedures - methods; Vena Cava, Inferior - diagnostic imaging; Vena Cava, Superior - diagnostic imaging; Azygous vein; Venous embolism; Retrograde migration; Migration; Retrograde; Junction; Circulatory system; Cardiology; Superior vena cava; Embolism; Femoral vein; Pneumology
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezs267

We report a case of a shrapnel injury to the right thigh in which a foreign body had lodged in, and moved freely from, the femoral vein to the inferior vena cava and right atrium. However, instead of going into the right ventricle and pulmonary artery, it lodged itself in the superior vena cava-azygous junction. During the entire period, the patient remained asymptomatic and the foreign body was surgically retrieved uneventfully.