A 21-year-old male was shot with a handgun in the mandible, chest, inguinal region, and upper limbs. Upon admission to the emergency room, vital signs were relatively stable.
X-ray examination of the head and neck region apparently revealed that the right side of the mandible was fractured and that the bullet-shaped radiopaque object was lodged in the tongue. However, because the radiopaque object in the tongue was found intraoperatively to be a full cast crown on the mandibular firstmolar, the initial clinical impression of the route that the bullet passed through the body proved to be mistaken. The comminuted mandibular fracture was reduced and stabilized with a miniplate under general anesthesia.
Five months later, after an abscess appeared in the right submandibular region, the remaining bullet fragments were surgically removed. The postoperative course was uneventful.
The unique characteristics of gunshot wounds shoud be carefully considered at initial assessment.
