A Rare Case of Dynamic Popliteal Artery Occlusion After Gunshot Injury with Reconstitution of Flow in the Frog-leg Position

A 16-year-old male was transferred to our institution shortly after a gunshot injury to the right lower extremity. Physical examination was remarkable for two bullet entry points in the right posterior leg. A right lower extremity computed tomography angiogram (CTA) demonstrated a retained bullet fragment in the right popliteal fossa and a 10 centimeter (cm) in length occlusion of the proximal peroneal artery with reconstitution of flow distally. A diagnostic angiogram of the right lower extremity with the patient’s leg extended demonstrated lack of popliteal arterial flow immediately distal to the retained bullet fragment. Reconstitution of vascular flow was appreciated once the patient’s leg was placed in the “frog-leg” position.