Penetrating bullet wound of chest with bronchoscopic removal of bullet.

A case history is presented of a patient with a penetrating bullet wound of the chest in whom the 0.38 caliber bullet was unexpectedly found entirely within the lumen of the right lower lobe bronchus at bronchoscopy. A second bullet penetrating the abdomen necessitated an extensive abdominal operation and delayed removal of the intrabronchial bullet by 1 day. During the 1 day interval, distal migration of the intrabronchial bullet caused technical problems in removal which are discussed. The bullet was successfully removed with a rigid bronchoscope without subsequent complications. The limited literature on this rare occurrence is reviewed, and suggestions are made concerning management.