Trans-mediastinal migration of Bullet – an unusual presentation

Abstract

Trans-mediastinal gunshot wounds are infrequent but life-threatening injuries requiring multiple diagnostic and therapeutic algorithms. Further intrathoracic migratory foreign bodies are a small but distinctive subgroup of missile injuries and should be removed when they need to be. We present an interesting case of an 18 year old male, who presented with trans-mediastinal migration of bullet which subsequently migrated from left hilum to right hilum. During surgery bullet was not found in the region of left hilum as was seen in the pre-operative X ray and CT scan. X-ray and CT scan in postoperative period revealed bullet near right hilum. Follow-up radiograph after six months revealed no further migration and patient continues to do well.