February 12, 1973

Tumbling Bullets

Author Affiliations

Dallas County, Tex

JAMA. 1973;223(7):798. doi:10.1001/jama.1973.03220070052018

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To the Editor.—  The article "The Sign of the Tumbling Bullet Revisited" (222:190, 1972) prompts the report of a similar case.A 33-year-old man entered the hospital with bullet wounds of the right wrist and abdomen. There were no exit sites noted. X-ray films of the chest, abdomen, neck, and head were negative for the trunk projectile. Immediate surgery disclosed passage of the wound track through the liver and into the inferior vena cava. Ligation of this vessel was performed, and during attempted removal of the damaged portion of the right lobe of the liver, the patient died.Prior to autopsy examination, postmortem x-ray films of the pelvis were performed and an intact missile was observed on the left side (Figure). A 0.22-caliber bullet was recovered in the left hypogastric vein. The sutured entrance wound into the vena cava was noted, with no exit site found. The missile penetrating the