Missile pulmonary embolus secondary to abdominal gunshot wound

Missile pulmonary emboli are rare sequelae of traumatic entry of projectile missiles—generally bullets or bullet fragments—in which access to the systemic venous circulation is established by the missile, making it possible for the missile to migrate to the pulmonary arteries. In the case introduced here, a 24-year-old male presented to the ER with a gunshot wound to the abdomen. In the early course of his care, it was determined that he had suffered a missile pulmonary embolus secondary to a large fragment of a bullet penetrating the IVC. Despite the large perfusion defect created by this missile embolus, the patient recovered uneventfully without embolectomy.