No abstract

The rarity of bullet emboli leads to frequent delays in diagnosis and inadequate early management. Our 8, 1986. O n admission to the emergency department his blood pressure was 110/65 mm Hg, heart rate 66 beats/min, respiratory rate 10 breaths/rnin. He was obtunded and underwent an immediate endotracheal intubation. No exit wound or other gunshot wound was detected. The initial x-ray film of the chest showed a bullet overlying the lower right lobe, and a right thoracostomy tube was inserted for a presumed injury to the diaphragm and right side of the chest (Fig. 1).Exploration of the abdomen revealed that the bullet had traveled cranio-caudally through the transverse mesocolon, injuring a loop of small bowel and entering the retroperito- SURGERY 239Br.