Asymptomatic pellet in the maxillary sinus: Medico-legal perspective

Air guns used for plinking are weapons with a short range and low velocity. Because of their low velocity, the ammunition usually enters the body without causing any immediate life-threatening complications. Lead toxicity is a potential side effect of a pellet lodged in the body. However, there are cases where blood lead level was below the reference value even after decades of an air gun pellet remaining in the body. We report a case of 40-year-old man whose X-ray of the skull revealed a metallic foreign body that appeared to be an air gun pellet in the maxillary sinus. The patient recalled receiving a gunshot wound to his left cheek ten years ago. The wound healed, the pain subsided, and the patient was symptom-free, so he did not seek medical attention. The present case study illustrates the incidental finding of impacted foreign body and its medico-legal aspects in the Nepalese context.