New fragmenting bullet leads to unexpected injury pattern: A case report involving the Radically Invasive Projectile

New developments in bullet technology are challenging what is commonly known about penetrating injuries from gunshot wounds. The so-called ‘bullet-rule’ posits the number of wounds and projectiles associated with a patient should add to an even number. This trauma paradigm is being shattered by the advent of new fragmenting projectiles. These frangible rounds break into several pieces after soft tissue penetration changing the expected trajectory, injury location, and extent of tissue damage. In this case report, the authors describe the case of a 15-year-old boy injured by a G2 Radically Invasive Projectile (RIP). The patient’s resultant pattern of injuries and the diagnostic utility of imaging were imperative for guiding his clinical management. The case serves as a useful example of the challenges and recommended strategies in managing a patient injured by a new fragmenting bullet