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<p>Ballistic embolization is a rare but clinically significant complication of injuries caused by nonpowder firearms. Despite numerous reported cases, a standardized and evidence-based management protocol for ballistic embolism has not been established. Treatment options range from endovascular extraction to open surgical removal or close surveillance with imaging. We report the case of a 10-year-old girl who sustained an accidental air gun injury to the neck, with recurrent migration of the pellet through the venous system and into the pulmonary arterial circulation. Multiple exploratory procedures at the referring center failed to locate the foreign body. After a definitive diagnosis was achieved via pulmonary CT angiography, a surgical embolectomy was performed via thoracotomy. The pellet was successfully retrieved without complications. This report highlights the diagnostic challenges, intraoperative considerations, and surgical decision-making required in the management of migratory intravascular foreign bodies in children, with the aim of contributing to the existing literature.</p>

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Air Gun Pellet Embolism: A Case Report of a Migratory Foreign Body in a Pediatric Patient

  • 期刊论文

  • 发表日期：

    2026年4月23日

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  • Elif Ilhan Sezer,
  • Denizhan Kilinc,
  • Hakan Isik,
  • Ersin Sapmaz

摘要

Ballistic embolization is a rare but clinically significant complication of injuries caused by nonpowder firearms. Despite numerous reported cases, a standardized and evidence-based management protocol for ballistic embolism has not been established. Treatment options range from endovascular extraction to open surgical removal or close surveillance with imaging. We report the case of a 10-year-old girl who sustained an accidental air gun injury to the neck, with recurrent migration of the pellet through the venous system and into the pulmonary arterial circulation. Multiple exploratory procedures at the referring center failed to locate the foreign body. After a definitive diagnosis was achieved via pulmonary CT angiography, a surgical embolectomy was performed via thoracotomy. The pellet was successfully retrieved without complications. This report highlights the diagnostic challenges, intraoperative considerations, and surgical decision-making required in the management of migratory intravascular foreign bodies in children, with the aim of contributing to the existing literature.