Peripheral Arterial Embolism of Pellets after Shotgun Injury to the Abdomen: A Case Report

Dealing with shotgun injury to the abdomen it is important to be aware of the possibility of missile emboli and their potential clinical effects because it usually causes vascular trauma but intravascular missile embolism is relatively rare. Vascular trauma following shotgun injuries may involve laceration of the vessel wall, pseudoaneurysm, arteriovenous fistula or missile embolism. A pellet embolus should be suspected in all cases where gunshot entry wound is present with or without an exit wound. We recently encountered a case of a close-range shotgun injury to the abdomen with subsequent embolisation of pellets to bifurcation of popliteal artery both lower limbs. However, pellet embolus is asymptomatic, there is still debate over best management because conservative management avoids surgical risks and operative removal prevents the possibility of embolus related life threatening complications.

This case shows that it is necessary to do whole body imaging in all cases of shotgun injury whether exit wound present or not.