Air Gun Pellet Injury to Internal Carotid Artery: A Case Report and Review of Literature.

Abstract

Airgun injuries are prevalent in the pediatric population. The present study described a case of air gun pellet injury to the left carotid artery and its successful management. A 25-year-old man presented to the emergency department complaining that his son had accidentally injured him with an air gun pellet while playing. The X-ray cervical spine revealed a single foreign body (pellet) located directly anterior to the C5-C6 vertebra. A CT angiography of the neck showed a spherical hyperdense object just anterior to the C6 vertebral body on the left side, 3 mm posteromedial to the left common carotid artery, which was most likely a pellet foreign body. The patient was sent to operation theatre (OT) for exploration. There was a rent in the internal carotid artery with active bleeding. After exerting both proximal and distal control, the rent was closed. Close air gun injury could result in gunshot wounds, as in the present case. Plain X-rays in AP and lateral view are required. Nonoperative management could be employed in a restricted group of patients with satisfactory outcomes. Those who have vascular involvement will require surgical intervention.