UNIQUE CASE OF SIMULTANEOUS ASPIRATION AND INGESTION OF TWO BULLETS AFTER A SINGLE FACIAL GUNSHOT WOUND.

Within the body, the bullets may have an unpredictable trajectory, which may pose diagnostic and treatment diffi culties. We present a patient, shot by automatic pistol of 7.65 mm caliber. The physical examination revealed a single facial gunshot wound without apparent exit wound, fi ve through-andthrough wounds of the extremities without chest or abdominal involvement. Quite unexpectedly, routine X-ray and subsequent CT scan revealed two projectiles, lodged in the right inferior bronchus and the proximal jejunum. Flexible bronchoscopy and upper endoscopy found no injuries of the trachea, bronchial tree and upper gastrointestinal tract, respectively. The bullet from the right bronchus was retrieved intact by rigid bronchoscopy, while the other was evacuated trough a normal defecation. To our knowledge, this is the fi rst case described in the literature. Despite casuistic, the aspiration or ingestion of the bullets should be considered in all cases of facial gunshot wounds without exit ones. Computer tomography allows excellent depiction of the projectile location and concomitant injuries and may help avoidance of unnecessary interventions [ABSTRACT FROM AUTHOR]