Superman

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.