Chronic Leg Ischemia Caused by Arterial Bullet Embolization

Intravascular shrapnel or bullet embolization after a gunshot injury is rare, with fewer than 200 cases reported over the past century. Military injuries typically have high energy transfer, making this phenomenon less prevalent. A 22-year-old military personnel presented with chronic leg ischemia resulting from arterial bullet embolization. Before 4 months, he had sustained a military injury and subsequently required hospitalization for pneumohemothorax. A 21-mm bullet obstructing the popliteal artery caused chronic leg ischemia and was scheduled for elective vascular surgery. Physicians should be aware of potential bullet embolization indications in gunshot wound patients to prevent complications, ensuring early detection and appropriate treatment for successful management.