Intra-myocardial Bullet causing heart block in a patient with multiple gunshot wounds: Case Report


Authors: Odhiambo W.A. 1 BDS, MDS (OMFS), Guthua S.W. 1 BDS, MMED SC, DOMS, FIAOMS, FCS, Munene J. 2, MBChB,

 MMed, Kariuki C. 3, MBChB, Mmed, FRCP Thanga P.W. 3 MBChB. Affiliations: 1 Department of Oral and Maxillofacial Surgery, University of Nairobi, 2 Kenyatta National Hospital, Nairobi, 3 The Nairobi Hospital. Corresponding Author; Dr. Walter Odhiambo, Department of Oral and Maxillofacial surgery, School of Dental Sciences, College of Health Sciences. P.O. BOX 19676, KNH, NAIROBI Tel 254-20-3873398 Cell 254-722-518616. E-mail:



Elective removal of intra-myocardial bullet remains a controversial subject. A non-operative approach has been recommended as appropriate for a stable asymptomatic patient. In the presence of complications such as bleeding, perforation leading to cardiac tamponade, thrombus formation, embolization, rhythm disturbances and infections, surgical removal may be advised. We present a patient who survived multiple gunshot wounds with a bullet lodged in the wall of the left ventricle of the heart. Details of the injuries sustained, operative removal of the bullet and the challenges that ensued are illustrated.


The Annals of African Surgery is the official publication of the Surgical Society of Kenya.


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