Expectoration of a bullet after gunshot wound to the chest

Over the last century, only four cases have been published of patients sustaining gunshot wounds to the chest, managed nonoperatively, who eventually expectorated the bullet. We report the case of a hemodynamically stable 24-year-old male whose bullet was found in the left pulmonary hilum on admission computed tomography (CT) scan. Further workup revealed no obvious aerodigestive injury. Shortly after extubation, he expectorated the bullet onto the floor. Little is known about how to manage these stable, yet challenging patients.