A penetrating gravitational bullets (stray bullets, falling bullets) injury to the clitoris: A case report

INTRODUCTION AND IMPORTANCE: Vulvar penetrating trauma is a rather uncommon occurrence (1). Firearm injuries caused by low-velocity gravitational bullets are a common cause of injuries in war-torn countries such as Somalia [2] (Campbell and Wilbert, 2022). These types of injuries are inflicted on by-standers by wayward bullets. No standard consensus on the appropriate management of vulvar penetrating trauma has been established (3). Here in, we report the successful management of an impacted bullet in the clitoris by a simple incision under local anesthesia. The principles of vulva and clitoris tired bullet trauma management are discussed. In our case, we thought it to be rare and interesting, considering its occurrence. CASE PRESENTATION: In this report, a 24-year-old woman (gravida 2, para 2) suffered from a vulvar area penetrating bullet injury. Imaging revealed that the foreign body was confined to the clitoris, and no evidence of other parts of the body. Under local anesthesia, the bullet was accessed and removed from the clitoris by performing a minor incision. No complications were observed following the surgical removal of the bullet. CLINICAL DISCUSSION: Non-obstetric vulva trauma is an extremely rare occurrence. Typically, the cause of non-obstetric vulvar trauma includes sports-related injuries, straddle injuries, and midline splitting injuries. To the best of our knowledge, this case is unique due to the bullet being retained in the clitoris. The treatment of the foreign body is mostly surgical removal. Under local anesthesia, this patient underwent complete surgical removal of the metallic foreign body. During surgical excision, care should be taken not to damage the urethra and other pelvic issues. CONCLUSION: To the best of our knowledge, this is the first wayward bullet (not intended for the patient) injury penetrating the vulvar area with a retained bullet in the clitoris. In our case, we thought it to be rare and interesting, considering its occurrence.