A 54-year-old male with no medical history was admitted to the emergency room with penetrating abdominal injury caused by an accidental air gun shot. Upon admission, he was hemodynamically stable and showed one entrance wound site on his abdomen (Fig. 1.). His plain X-ray and CT (Fig. 2.) revealed a bullet located in the abdomen wall. Accordingly, we planned an emergency surgery and detected omental injury, perforation of the anterior and posterior walls of the stomach, and multiple perforations of the ileum (at 5 sites) (Fig. 3.). We then performed primary repair of the stomach and ileum and removed the bullet. The patient recovered without any complications.

The gunshot injury wound depends on the characteristics of bullet yawing, position, and section of the wound ballistics or profile [1]. Gunshot injury from a bullet traveling at a speed of <1100 ft/s is considered a low-velocity injury, such as with an air gun. Conventionally, the standard choice of treatment for gunshot wounds in the abdomen has been laparotomy [2]. Lee et al. reported several combat-related gunshot injury cases in South Korea; however, gunshot injury cases are relatively rare in South Korea [3]. Despite of this, we need to be prepared for proper management of such cases in the future.