Bullet Embolus to the Pulmonary Artery After Gunshot Wound to the Face: Case Report and Review of Literature

Abstract

Gunshot wounds to the face can have devastating effects on local and distant tissues. The amount of local damage is directly proportional to the kinetic energy transmitted by the missile. Distant injuries, not in the path of the bullet, can be incurred by a pressure wave created by the temporary cavity, a secondary projectile, aspiration of the missile or bony fragments, and embolization of the bullet, which is a rare phenomenon. Embolization, aspiration, and ingestion of the missile should be suspected when there is an entry wound but no exit wound and no missile is found on x-ray in the expected area after a gunshot wound to the head and neck. Bullet embolism to the heart after gunshot wound of the mandible has been reported in the literature. There are several case reports of bullet embolization to the pulmonary artery after sustaining gunshot wounds to the chest, abdomen, and/or extremities. The purpose of this article is to present a case of bullet embolization to the pulmonary artery after a gunshot wound to the face, fracturing the mandible along its course, to review the literature, and to offer a strategy for managing such injuries.