Venous embolization of metallic mercury is rare. It results from the accidental or deliberate injection of mercury into a peripheral vein. In most cases, the clinical manifestations, if any, are mild and of short duration; supportive care suffices; and prognosis is good.
Findings on chest radiograph are striking and should immediately suggest the diagnosis. One or both lungs invariably contain multiple, tiny, dense spherules diffusely distributed or confined primarily to dependent areas. These spherules sometimes appear as beaded chains filling pulmonary arterioles, giving an “angiogram effect.” Occasionally, mercury can be seen in the heart, especially in the right ventricle where it tends to pool.
Because mercury can pass through the pulmonary capillary bed or around it via shunts, mercury emboli may be visible in radiographs of the head, neck, abdomen, or pelvis. The presence of metallic densities in these sites or in the heart, coupled with the aforementioned pulmonary abnormalities, differentiates mercury embolism from all other diagnostic considerations, particularly aspiration of mercury. We present here three cases that illustrate different degrees of metallic mercury embolism.
- Copyright © 1995 by American Heart Association