[Embolization of the brachial artery by lead-shot with ischemic syndrome]

Pre-operative arteriography in a 5-year-old girl with a gun-shot wound of the shoulder demonstrated the presence of an arterial embolus at the elbow provoking an ischemic syndrome. Following re-establishment of circulation by embolus extraction the arterial perforation at the point of entry was repaired by a venous graft, loss of shoulder substance being treated by a musculocutaneous flap from the latissimus dorsi region. Pre-operative arteriography should be a routine investigation in patients with ischemic syndromes of the limbs following injury from penetrating projectiles.