The pulsatile pain of acute aortic dissection: A neurosurgeon's personal experience

thrombus formation resulting from the endocardial damage caused by thermal injury or mechanical injury leading to a localized contusion by the pellet. In this case with multiple gunshot wounds TEE was useful for detecting a mobile right ventricular outflow tract thrombus, which is uncommon after gunshot injury and a pericardial effusion and intramyocardial foreign body. The TEE findings led to successful surgical removal of a pellet and a thrombus in the right ventricular outflow tract, which is likely to be at risk for embo]ization to the pulmonary arterial tree.