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People with shotgun pellets embedded in their bodies can live comfortably with them for years, doctors
said.
The pellets are usually non-life threatening if the person’s body does not react adversely to the metal, they said.
But complications can result, such as infections and lead poisoning.
Very few such cases have surfaced in Singapore, but one made the news last week.
It was reported that on March 13, two Singaporean soldiers on night training in Thailand were accidentally shot at by a farmer with a shotgun.
One of them, Private J. Pritheevy Raj, 19, still has a pellet lodged in his right cheekbone and another in his right shoulder.
Another soldier, First Sergeant Woo Teng Hai, 25, a regular commando, suffered head injuries and is said to be blind in his right eye.
Shotgun pellets are small metal spheres like ball bearings. They range from about 1mm to about 10mm in diameter.
The pellets are encased in a shell, said Mr Norman Lim, managing director of ballistics armour maker Fral.
When shot, the shell breaks open, spraying the pellets in a circular pattern, he said.
A shotgun is usually used to hunt animals or birds using pellets half the size of a pea.
The pellets rarely kill people but can maim.
“On the other hand, a bullet is made to kill,” Mr Lim said.
While pellets lodged in a body are usually removed, they are sometimes left there, said doctors.
Dr Cosmas Chen, a general surgeon in private practice, said that it is sometimes better to leave a pellet than to extract it.
“Pellets from a shotgun can be very small. The entry point of a pellet may be only a few millimetres, but doctors may need to cut a few centimetres to extract it,” he said.
This may cause more damage to the body than if the pellet was left alone.
Dr Chen said the pellets are usually non-life threatening if they are made of materials that do not cause an adverse reaction in the body.
“If it is lodged under the skin, then it is much like a tattoo,which is harmless. So it’s a risk-benefit analysis as to whether we should remove them from a patient or not,” he said.
Dr Malcolm Mahadevan, head and senior consultant at the emergency medicine department at the National University Hospital, likened living with a pellet to having metal placed in the body from a fracture.
“You may not even feel it after a while,” he said.
Pte Pritheevy, for example, was reported as saying he “feels fine” except for occasional headaches.
Such pellets may be difficult to find, in which case they obviously cannot be removed.
The body often reacts to a foreign body by growing flesh around it, creating a swelling known as fibrosis.
“The swelling is usually harmless, but if it occurs superficially, it can then indicate where the pellet is and we can remove it. This usually happens in a couple of weeks,” said Dr Mahadevan.
This does not mean that there are never any complications.
Dr Chen said that if a pellet is lodged inside an air-filled bone, like the sinuses in the face, there is a possibility that infection will occur.
Added Dr Mahadevan: “If there is bacteria on the surface of the skin when the pellet penetrates it, it could infect deeper tissues. And if the pellet contains a metal like lead and there are many pellets in the body, there is the possibility of lead poisoning over time.”
He said that if a patient experiences lead poisoning symptoms like anaemia, he should visit a doctor at once.
Doctors also said the pellets could move or migrate if they were embedded in deeper loose tissue and get into organs or the blood stream.
Bullets, however, are less likely to migrate because they are bigger.
Metals in the body might cause metal detectors to beep.
Doctors said people with bullets or pellets embedded in their bodies should declare them to the authorities before walking through, say, a metal scanner at the airport.
Said general surgeon Chan Hsiang Sui: “It may be safer if the patient carries a letter to certify that he has such materials in the body to avoid unnecessary delays and inconvenience at international airports.”
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