The history the man provided initially was vague and seemed evasive, or at least uncertain. He had never seen a doctor about the complaint until his general practitioner referred him to me. I subsequently obtained an xray of his pelvis which showed a 22 bullet within the left ischial tuberosity and surrounded by an expanded bony cyst which was reactive. It was apparent that the history required more disclosure.
The patient confided that he had been surreptitiously visiting the wife of a man who suspected her of a sexual liaison. The irate husband waited for proof and received it when he opened the bedroom door with a loaded 22 rifle in hand. My patient was frantically clearing out of the bedroom window when he received the gunshot wound in his left buttock.
This patient was fortunate on several counts. The offended male never saw his face and couldn't describe any other identifying features on his buttocks. He was shot with merely a 22 and so was on the fuel of adrenaline, able to run, hide and avoid a hospital or clinic. The bullet remained intraosseus because of its low velocity and the high resistance of the bone. Because of that it did not stray into bowel or bladder where much damage would have ensued.
This subsequent surgical operation is always called, "removal foreign body" . I practiced a busy orthopedic practice from !963 to 2001. That is the only gunshot case I ever had in a practice in Canada that included at least 600 surgical operations a year. That would include self afflicted injuries. Imagine that in contrast to our unfortunate neighbour to the South with the second amendment alive and well and others not !