Incidence, Pattern, and Outcome of Stray Bullet Injuries: Three Years’ Experience in a Teaching Institute
Objectives: The purpose of this study is to better define the incidence, pattern, and outcome of a stray bullet.
Materials & Methods: The current study summarizes the data on stray bullet injuries presented to the Emergency Department (ED) Hayatabad Medical Complex, Peshawar. A total of 24 subjects were included for three years. We enrolled all patients who had head or spine injuries caused by a stray bullet. Data were extracted on demographic profile, site of injury, operative procedure, complication, and mortality, and were recorded on prescribed proforma.
Results: A total of 24 subjects were included for 3 years. 17 (70%) were male patients and 7 (30%) were females. Male to female ratio was 2:1. out of 24 cases, 9 (37.5%) were from District Peshawar, 3 (12.5%) cases were from Mardan and Charsadda District, and 2 (8.3%) cases were from Swat. 12 cases had a bullet in the Head and face. out of which 7 were supratentorial 3 cases had a bullet in the posterior fossa. Out of 24 cases, 13 (54.1%) were operated for the removal of bullets. 5 (20.8%) developed focal or generalized fits. 13 (54.1%) developed a neuro deficit. 4 (16.6%) of cases remain in a vegetative state, and the overall mortality rate is 20%.
Conclusion: Morbidity and mortality due to stray bullets is an increasing problem in our society. This study aims to bring awareness among the concerned authorities to try and bring an end to this menace resulting in deaths and misery.
Ali SA, Tahir SM, Makhdoom A, Shaikh AR, Siddique AJ. Aerial firing and stray bullet injuries: A rising tide. Iran Red Crescent Med J. 2015; 17 (4).
Batley N, Bakhti R, Bachir R, Mufarrij A. Stray bullet injuries in a tertiary care center. Signa Vitae. 2016; 12 (1): 106–10.
Fei SY, Chiang JT, Fei CY, Chou CH, Tung MC. Guidelines on stray dog population control - OIE. Environ Ecol Stat [Internet]. 2012; 4 (4): 485–98.
Malik AM, Alkadi A, Altaf Hussain Talpur K, Qureshi JN. The incidence, pattern and outcome of stray bullet injuries: A growing challenge for surgeons. Pakistan J Med Sci. 2013; 29 (5): 1178–81.
Wintemute GJ, Claire B, McHenry V, Wright MA. Stray bullet shootings in the United States. JAMA – J Am Med Assoc. 2011; 306 (5): 491–2.
Wani A, Ramzan A, Shoib Y, Malik N, Nizami F, Dhar A, et al. Stray bullet: An accidental killer during riot control. Surg Neurol Int. 2011; 2 (1): 122.
Rhee PM, Moore EE, Joseph B, Tang A, Pandit V, Vercruysse G. Gunshot wounds: A review of ballistics, bullets, weapons, and myths. J Trauma Acute Care Surg. 2016; 80 (6): 853–67.
Wintemute GJ, Claire BE, S. McHenry V, Wright MA.
Epidemiology and clinical aspects of stray bullet shootings in the United States. J Trauma Acute Care Surg. 2012; 73 (1): 215–23.
Abdali H, Hoz SS, Moscote-Salazar LR. Cranial gravitational (falling) bullet injuries: Point of view. J Neurosci Rural Pract. 2018; 9 (2): 278–80.
Report C. Stray Bullet Penetrating Deep Into Brain Without Causing Neurological Deficit, 2010: 110–1.
Martucciello G, Tripodi R. A stray bullet in the brain. Lancet [Internet], 2012; 379 (9812): e19. Available from: http://dx.doi.org/10.1016/S0140-6736(11)60703-4
Schulz C, Woerner U, Luelsdorf P. Image-guided neurosurgery for secondary operative removal of projectiles after missile injury of the brain. Surg Neurol. 2018; 69: 364-8.
Shah AA. Stray bullet in N.W.F.P. Journal of Postgraduate Medical Institute, 1994; (8): 59-61.
Sezer C, Gokten M, Gezgin ?, Sezer A, Binboga AB, Onay M. Spontaneous migration of a bullet in the cerebrum. J Surg Case Reports, 2021; 2021 (4): 1–2.
Ramos A, Alan M, Jose DE, Hector SM, Dolores LG, Marin HS, et al. Surgical management of late bullet embolization from the abdomen to the right ventricle: Case report. Int J Surg Case Rep [Internet]. 2017; Available from:
Hussain M, Bari E. Intracerebral migration of stray bullet leading to sudden and fatal worsening. J Coll Physicians Surg Pakistan, 2017; 21 (3): 182–3.
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