Get the lead out-unusual ballistic patterns can lead to diagnostic delay

Abstract

Slingshot injuries have been rarely reported in the literature and while the value of three dimensional imaging, intravenous antibiotics and exploration under anaesthesia remain the mainstay of treatment, this case highlights the need for careful examination when the clinical presentation is seemingly innocuous. Our initial working assumption was that the palpable lump was likely to be an old injury, supported by the single small laceration which seemed an unlikely entry wound due to its size and distant anatomical location. However, blunt exploration of the would revealed a tract, favouring emergent rather than elective management. We therefore highlight to the maxillofacial community the possibility of explosive residue having migrated or being found distant to impact location.