Pellet embolization to the right atrium following double shotgun injury

A 28-year-old man sustained two shotgun injuries of the left inguinal regio n from a distance of about 1.5 m by simultaneous discharge of both shells f rom a sawn-off double-barrelled 16-bore shotgun (diameter of the lead pelle ts, 4 mm). The first X-ray examination carried out soon after hospital admi ssion showed a single embolized pellet near the right margin of the cardiac silhouette. Eight months later, the man committed suicide by drug intoxica tion. At autopsy, the embolized pellet was found embedded between the pecti nate muscles of the right atrium. On the basis of the reported case and wit h reference to the pertinent literature, the paper points out the medico-le gal aspects of venous bullet/pellet embolism and the risk of lead poisoning after shotgun injury. (C) 1999 Elsevier Science Ireland Ltd. All rights re served.