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Case Reports
. 2023 Nov 8:11:444-448.
doi: 10.1016/j.toxrep.2023.11.004. eCollection 2023 Dec.

"Heavy Metal": Management of lead toxicity following a gunshot injury with retained lead fragments, a case report

Ilaria Costantini  1 , Massimo Carollo  2 , Lorenzo Losso  3 , Elia Morando  1 , Matilde Bacchion  1 , Giovanni Mantelli  1 , Mauro Pizzuto  4 , Letizia Spagnuolo  4 , Maria Vittoria Ventura  4 , Giorgio Ricci  1
Affiliations
Case Reports

"Heavy Metal": Management of lead toxicity following a gunshot injury with retained lead fragments, a case report

Ilaria Costantini et al. Toxicol Rep. .

Abstract

There is limited literature on managing chronic lead exposure from non-removable sources such as lead fragments. In this case report, we present the complexities and clinical considerations involved in treating an elderly patient who sustained a comminuted knee fracture due to a gunshot wound, complicated by retained lead fragments. This case highlights the absence of comprehensive guidelines for managing chronic lead exposure when complete fragment removal is impractical. It also emphasizes the importance of a multidisciplinary approach to decision-making, while considering patient autonomy in such unique clinical scenarios.

Keywords: Chelation therapy; Lead poisoning; Poison control centers; Poisons; Toxicology.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

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Graphical abstract
Fig. 1
Fig. 1
Radiographies at first evaluation in the Emergency Department.
Fig. 2
Fig. 2
Photography of the wound (right knee) before the surgical intervention of debriding, followed by knee arthroplasty.
Fig. 3
Fig. 3
X-ray radiograpies of the right lower limb after surgical interventions.
See this image and copyright information in PMC

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