Hemoptysis resulting from endobronchial migration of a bullet 10 years after chest injury

Late complications occur in only in a small percentage of patients with thoracic gunshot injury as a result of remaining bullets. These complications include pneumonia, empyema, hemoptysis, and embolization of the bullet. We describe a 36-year-old man who presented with hemoptysis. He was wounded in 1994 by a gunshot. Ten years after the initial event, one of the remaining 2 bullets migrated endobronchially into the right lower lobe bronchus, causing recurrent hemoptysis. During an 8-year period, several attempts were performed to stop the hemoptysis by embolization of (branches of) the bronchial artery. Eventually, after embolization of all collateral arteries surrounding the bullet, it could be removed successful by rigid bronchoscopy without complications. It is concluded that embolization of the collateral vascular network surrounding a foreign body and the subsequent removal of the foreign body should be considered in patients with recurrent hemoptysis.