This is a crazy case that I ran across last week. This guy was being robbed and was shot
in the face at close range. He put
his right hand up in defense as the gun went off. As is usually the case with bullets, your hand is not the
best defense. The bullet went
through and through his right hand and then into his face via his right upper
lip. His hand was fine, no broken
bones and completely neurovascularly intact.
As you can see by the facial x-ray, the bullet knocked out
some of his teeth on its way through his oral cavity, somehow missing his
tongue completely. There was no
exit wound on the other side of his face.
He also had a gunshot wound to his abdomen for which we had
to take him to the operating theatre for an emergency laparotomy. He had 12 holes in his small bowel from
the bullet that went though his abdomen and we were able to resect the entire
damaged portion of intestine in one piece and do a primary anastamosis. Sometimes this is much better than
fixing all of the individual holes as long as the section you have to take out
isn’t too big. It’s better to have
one single suture line than 12 separate repairs. There is a substantially smaller chance of having a leak
postoperatively that way.
He did well after the case and was transferred to the ward
for routine postoperative care. The
following morning on rounds, he surprised us all. He spit the bullet out of his mouth!!! I’ve only seen something like that in
movies, never in real life. It had been lodged in his left cheek and when he woke up from the anesthetic, he was able to spit it out. Incredible.
