An Accidental Gun Discharge Left a Bullet Inside His Neck

The patient Al (pseudonym), is a 37-year-old Yemeni man. Eighteen years ago, while bending down to put on his shoes, he accidentally discharged a pistol in his jacket pocket. The bullet entered from the left side of his nose area and traveled toward the area below his left ear, eventually becoming lodged in his neck.

At a local hospital, physicians said that Al was extremely fortunate. Because the bullet had not caused life-threatening injury and was located in a relatively stable position. Doctors removed visible bullet fragments but were unable to extract the main bullet due to limited visibility. At that time, physicians explained that the bullet was located in an area considered relatively safe. Surgical removal could potentially carry greater risks because of the dense distribution of important nerves and major blood vessels in the neck. After careful consideration with his family, Al decided to temporarily leave the bullet in place and undergo regular medical follow-up. 

Living with a Bullet for 18 Years: A Life Controlled by Fear and Uncertainty

In 2004, Al moved to Guangzhou, China, to help manage his brother’s retail business. Over the years, the retained bullet became a constant psychological and physical burden. “I could not fully lift my head, look backward, or do intense exercise. Even changes in weather or emotional stress seemed to trigger discomfort,” he described.

For 18 years, whether in Arab countries or in China, Al had visited numerous hospitals, consulted multiple specialists, and sought expert opinions. However, because of the bullet’s complicated location and the potential surgical risks, doctors were reluctant to perform removal surgery. He could only undergo regular examinations while continuing to live with the uncertainty. Despite the long-term burden, Al continued building his career in China. He eventually married a Chinese woman from Hunan Province, had two daughters, and developed a deep affection for China. He was actively preparing to apply for permanent residency in China. 

A New Warning Sign: The Bullet Penetrated the Hypopharyngeal Wall

In March 2020, Al suddenly developed a sensation of something stuck in his throat accompanied by coughing. Because the COVID-19 pandemic was widespread at the time and there were no obvious signs of throat inflammation, he initially suspected that the symptoms might be related to the retained bullet.

A fiberoptic laryngoscopic examination at another hospital showed no obvious abnormality, and his symptoms temporarily improved, so he did not seek further treatment. However, in late August, the throat discomfort returned and was accompanied by pain.

On September 1st, Al visited the Department of Otolaryngology–Head and Neck Surgery at Guangdong Clifford Hospital. During electronic laryngoscopy, Dr. Wang Huimin, associate chief physician, identified a clearly visible foreign object on the posterior wall of the left hypopharynx. “Waiting was no longer an option. Surgery needed to be arranged immediately,” the physician stated. 

Careful Surgical Planning and Precise Removal of the Retained Bullet

Foreign bodies in the pharyngeal region are common emergencies in otolaryngology. If not properly managed, they may lead to delayed treatment and serious complications. After identifying the bullet, Wang Huimin immediately consulted with specially appointed expert Dr. Wang Tao, Associate Chief Physician, from the Department of Otolaryngology at The Third Affiliated Hospital of Sun Yat-sen University. Through comprehensive examinations, the medical team carefully evaluated the relationship between the bullet, surrounding blood vessels, cervical spine structures, and adjacent tissues. Based on these assessments, the team developed a detailed surgical plan using suspension laryngoscopy combined with low-temperature plasma-assisted foreign body removal.

A Delicate Procedure: Successfully Removing a Bullet Retained for 18 Years

Following comprehensive preparation, Dr. Wang Tao, Associate Chief Physician, led the surgical team, including attending physician Chen Yanfang, in performing the procedure under safe general anesthesia. Although part of the bullet had already become exposed, the surgical team remained extremely cautious due to the complex anatomy of the neck region and the potential risks associated with surrounding tissues.

Using low-temperature plasma technology, the surgeons carefully removed adhesions and tissue surrounding the bullet, creating a clear and controlled surgical field while minimizing the risk of bleeding.

The team then used alligator forceps, which is typically used for esophageal foreign objects, to carefully grasp and remove the bullet. “The procedure was completed smoothly. The surgical cavity was clean, with no oozing or bleeding and no additional complications,” said Dr. Wang Tao. 

After 18 Years, the Hidden Risk Was Finally Resolved

The bullet that had remained inside Al’s throat region for 18 years was successfully removed. Following surgery, his recovery progressed smoothly. On September 8, the surgical wound had healed well, and Al was discharged from Guangdong Clifford Hospital in good condition. The long-standing physical discomfort and psychological burden caused by the retained bullet were finally relieved. 

A Heartfelt Return: Patient Expresses Gratitude Through a Trilingual Thank-You Letter

After the 18-year concern was resolved, Al expressed deep gratitude to the medical team from the Department of Otolaryngology–Head and Neck Surgery at Guangdong Clifford Hospital. On the afternoon of September 11, after discharge, he personally returned to the hospital and presented physicians and nurses with a heartfelt thank-you letter written separately in Chinese, English, and Arabic, along with gifts of chocolate. His sincere words reflected the profound impact the medical care had on him and his family. 

“You Gave Me a New Life”

Al shared that September 1, 2020, the day he came to Guangdong Clifford Hospital, was not only the first day of his children’s new school year but also the first day of his own renewed life.

He expressed his gratitude to Professor Wang Tao for removing the source of his physical pain, emotional distress, and the long-term worries carried by his family and friends. “You may have performed countless surgeries and saved many patients throughout your career. This operation may seem like only one among many to you, but for me and my family, it completely changed my life. It gave me a new beginning,” he wrote.

He also expressed his gratitude to Dr. Wang Huimin, Dr. Chen, and the nursing team:

• “When Dr. Wang Huimin saw my laryngoscopy results, your concerned and urgent expression showed me that you truly considered my situation from the patient’s perspective.”
• “Dr. Chen and the nurses came several times every day to check my wound, making sure there was no negligence and that everything was progressing safely.”
• “The warmth and kindness you showed me touched me deeply and reminded me of the care and comfort that only a mother could provide.” 

Medical Reminder: Retained Metallic Foreign Bodies Should Be Removed Whenever Possible

Professor Wang Tao explained that, in general, bullets and other metallic foreign bodies are not recommended to remain inside the human body permanently. The body may develop foreign-body reactions, and retained bullets may shift with muscle movement, creating unpredictable risks. In addition, living with a retained foreign object may place significant psychological stress on patients.

For patients like Al, where the bullet is located in a highly complex anatomical region and immediate removal carries substantial risk, regular monitoring is necessary. Fortunately, after the bullet penetrated toward the pharyngeal region, Al sought medical attention promptly, allowing the complication to be identified and treated before more serious consequences developed.

Additionally, research has also suggested that retained bullets may potentially contribute to chronic lead poisoning, which further lead to complications including arthritis, constipation, abdominal pain, and weight loss. Therefore, when medical conditions permit, retained metallic foreign bodies should generally be removed to reduce potential long-term risks.