Major Vascular Neck Injury From a Handgun Cartridge CasingGuerrero, Alejandro MD*; Vassallo, David J. FRCS†American Journal of Forensic Medicine & Pathology: December 2010 - Volume 31 - Issue 4 - pp 388-389 doi: 10.1097/PAF.0b013e3181fc357d Case Reports Abstract Author Information We present a case from the Johannesburg General Hospital of a zone II low-velocity penetrating neck injury with involvement of the ipsilateral subclavian artery. When the "bullet" was retrieved, it was noted not to be an actual bullet but rather a cartridge casing. We speculate that this injury represents one of several possible misfiring scenarios from a homemade firearm. Injuries from homemade firearms are infrequent in the literature, and only one other similar case of a cartridge casing causing a penetrating injury was found. A brief review of homemade handheld firearms is offered. From the *Intertrauma Medical Consulting, New York, NY; and †Johannesburg Trauma Unit, Johannesburg, South Africa. Manuscript received June 22, 2007; accepted July 1, 2007. Reprints: Alejandro Guerrero, MD, Intertrauma Medical Consulting, Suite 3A3, 138 Mulberry St, New York, NY 10013. E-mail: email@example.com. © 2010 Lippincott Williams & Wilkins, Inc.