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September 10, 2003

Spontaneous Extrusion of Hand Grenade Fragments From the Face 60 Years After Injury

JAMA. 2003;290(10):1317-1318. doi:10.1001/jama.290.10.1317

To the Editor: Retained grenade fragments may slowly migrate in the body over time and thus may not become symptomatic for many years. For instance, Wittich1 reported a case of a grenade fragment that migrated from the leg 35 years after injury. Similarly, retained shrapnel may migrate several decades after the original injury and has been reported to cause late effects such as biliary obstruction,2 bowel perforation,3 and brain abscess.4 These reports describe cases in which the fragment is embedded in a relatively large space within the body. Herein I report a case of fragment extrusion from the face 60 years after the original injury.