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A 17 year old girl is brought to the emergency room for an air gun shot (pellet) into her mouth. On presentation she had only mild pain on her right cheek. The entrance of the pellet was on right buccal mucosa about 2 cm behind the oral commissure. No foreign body was palpable in the surrounding soft tissue. She had no trismus or parotid edema, and the throat, neck and cranial nerve examination were all normal. CT was performed and the metal foreign body was found to be in the right parapharyngeal space lodging on the styloid process (Figure 1). Angiography was done and the pellet found to be in touch with internal carotid artery (Figure 2). The vessel wall was intact; considering the possible risk of surgical intervention in this zone conservative management was preferred. The patient was followed for 6 months with no deleterious event.

A PENETRATING PELLET JEOPARDIZING INTERNAL CAROTID ARTERY