Wandering intravascular air gun BB pellet

Abstract

Approximately 13,500 children each year are treated for non-powder gun injuries of which approximately one-quarter of these injuries are puncture wounds. Although rare, vascular migration of the bullet or pellet (otherwise known as the “wandering bullet”) may result in downstream organ damage secondary to vascular or venous occlusion, most commonly travelling anterograde and lodging within the lung venous system. Interestingly, we present a case of a 12-year-old female who was shot in the neck with a compressed-air gun loaded with ball-bearing pellets. Eventual retrograde vascular migration of the ball-bearing pellet from the right internal jugular vein to the hepatic vein caused hepatic venous occlusion and congestion. It is important for radiologists to remember the possibility of retrograde travel of bullets and pellets, and radiographs should be scrutinized for foreign bodies present in areas other than the region of injury. Bullet retrieval is determined by clinical evaluation and necessity, and if indicated, endovascular, percutaneous retrieval, or surgical exploration may be considered.

Extraction of Air Gun Pellet in Lung Base Thoracic Vertebrae Region with Lateral Extracavitary Approach: A Case Report

“…Depending on the type of air gun employed, whether springpowered or pneumatic, the projectile's velocity can span from 82.5 m/s to 136 m/s. In contrast, bullets fired from firearms travel at significantly higher velocities, starting at a minimum of 227 m/s (Jafroodifar et al, 2020).…”

“…These pellets exhibit distinct characteristics compared to bullets used in conventional firearms, particularly regarding the pressures they encounter (Alakhfash et al, 2020). Typically, air gun pellets have diameters within the range of 4.5 mm to 6 mm and possess a mass of approximately 0.2 grams (Jafroodifar et al, 2020). Achieving a critical projectile velocity of 70 m/s is essential for these pellets to penetrate human skin (Dumenčić et al, 2020).…”

“…Injuries resulting from air guns can exhibit significant variation depending on factors such as the specific body area affected, the type of air gun employed, the shooting distance, and the age of the injured individual. In the context of Air gun pellet injuries, roughly 24.1% manifest as puncture wounds (Jafroodifar et al, 2020). The range of injuries caused by these pellets spans from minor skin abrasions to severe and potentially lifethreatening conditions, like lung lacerations and contusions.…”

Penetrating carotid artery injury by air rifle: a case report

“…One of the aims of this presentation is to raise the public and the surgical community's awareness of the danger airguns represent. Apart from other serious sequelae, vascular injuries caused by small-sized airgun pellets carry the risk of embolisation and the resulting downstream organ ischemia [ 5 – 7 ]. Despite comparatively strict regulations against firearms in New Zealand, air rifle regulations are much looser.…”