title: The elusive slug: bullet intestinal "embolism".
abstract: Bullet retrieval from the body of a gunshot victim is one of many tasks in post-mortem forensic examination. Rarely, it is complicated by the migration of the missile away from the entry point by vessel embolism. Abdominal firearm injuries, in which the bullet enters the intestines and moves inside the lumen away from the point of penetration, are even less common. We present a case of postmortem recovery of a bullet from the intestines of a gunshot victim who died 18 days after being shot in the trunk by three low velocity bullets. A missile had moved within the colon during hospitalization and postmortem handling of the body and was recovered from the sigmoid colon. This case demonstrates an extremely rare type of bullet "embolism" and emphasizes the usefulness of CT scanning in the location of projectiles.
authors.affiliation: The National Center of Forensic Medicine, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 67 Ben-Zvi Road, POB 49015, 61490 Tel Aviv, Israel. alon.krispin@forensic.health.gov.il
authors.forename: Alon
authors.initials: A
authors.lastname: Krispin
authors.forename: Konstantin
authors.initials: K
authors.lastname: Zaitsev
authors.forename: Jehuda
authors.initials: J
authors.lastname: Hiss
mesh_terms: D000007:Abdominal Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D001344:Autopsy; D003106:Colon / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D017809:Fatal Outcome; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology*; D044709:Forensic Ballistics; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery
references.citation: MMWR Surveill Summ. 2009 Mar 20;58(1):1-44
references.pmid: 19305379
references.citation: Am J Emerg Med. 2008 Sep;26(7):842.e1-2
references.pmid: 18774066
references.citation: J Surg Educ. 2008 Sep-Oct;65(5):340-5
references.pmid: 18809162
references.citation: Eur J Vasc Surg. 1993 Jul;7(4):467-9
references.pmid: 8359309
references.citation: Forensic Sci Int. 2003 Dec 17;138(1-3):8-16
references.pmid: 14642714
references.citation: World J Surg. 2002 May;26(5):539-43
references.pmid: 12098041
references.citation: Isr Med Assoc J. 2007 Jun;9(6):484-5
references.pmid: 17642402
references.citation: Asian Cardiovasc Thorac Ann. 2007 Apr;15(2):154-6
references.pmid: 17387200
references.citation: Ann Surg. 1977 Mar;185(3):318-20
references.pmid: 320947
references.citation: S Afr J Surg. 1981 Jun;19(2):145-9
references.pmid: 7025254
references.citation: Br J Radiol. 2007 Dec;80(960):e296-8
references.pmid: 18065636
references.citation: J Trauma. 1996 Jun;40(6):1034-6
references.pmid: 8656462
references.citation: J Trauma. 1998 Feb;44(2):394-7
references.pmid: 9498520
references.citation: Ann Surg. 2006 Oct;244(4):620-8
references.pmid: 16998371
references.citation: J Trauma. 2002 Oct;53(4):790-2
references.pmid: 12394887
references.citation: J Natl Med Assoc. 1988 Jun;80(6):678-9, 682
references.pmid: 3292777
references.citation: Ann Emerg Med. 1987 Jan;16(1):102-4
references.pmid: 3800059
references.citation: Surgery. 1990 Mar;107(3):239-45
references.pmid: 2408175