ABSTRACT
Dealing with shotgun injury to the abdomen it is important to be aware of the possibility of missile emboli and their potential clinical effects because it usually causes vascular trauma but intravascular missile embolism is relatively rare. Vascular trauma following shotgun injuries may involve laceration of the vessel wall, pseudoaneurysm, arteriovenous fistula or missile embolism. A pellet embolus should be suspected in all cases where gunshot entry wound is present with or without an exit wound. We recently encountered a case of a close-range shotgun injury to the abdomen with subsequent embolisation of pellets to bifurcation of popliteal artery both lower limbs. However, pellet embolus is asymptomatic, there is still debate over best management because conservative management avoids surgical risks and operative removal prevents the possibility of embolus related life threatening complications. This case shows that it is necessary to do whole body imaging in all cases of shotgun injury whether exit wound present or not.
Subject(s)
Abdomen/injuries , Adult , Arteries/injuries , Autopsy , Embolism/etiology , Foreign Bodies , Firearms , Forensic Ballistics/methods , Humans , Male , Peripheral Arterial Disease/etiology , Wounds, Gunshot/complications , Wounds, Gunshot/mortalityABSTRACT
Shotguns were developed as an alternative to single-missile rifle or handgun in order to enable gunner to spray a wide area with shot and thus kill birds and small animals too difficult to hit with single-missile weapons. As the popularity of shotguns grew, ammunition was developed for large game. The use of shotguns on humans has been markedly increasing in various manner of death. In forensic aspect, the shotgun wounds have characteristic findings due to their own characteristics and medical examiners may determine the range, distance, direction and kinds of gun. When the muzzle of the shotgun is placed tightly against the surface of the abdomen or thorax, the consequent wound of entrance will be single in number and circular in shape, and will have a diameter approximately equal to that of the bore of the weapon. However, when the wound is made over a site with underlying bone, especially in the scalp, the wound may have a different appearance, showing star shaped entrance due to tears from the sides of the wound and accompanying soot and burn effect. When the muzzle is held short to mid-range, considerable variation occurs in the appearance of the wound. We report two cases of shotgun wounds which showed typical findings of contact shots and distant shots.
Subject(s)
Animals , Humans , Abdomen , Birds , Burns , Coroners and Medical Examiners , Firearms , Scalp , Soot , Thorax , Weapons , Wounds and InjuriesABSTRACT
Shotguns were developed as an alternative to single-missile rifle or handgun in order to enable gunner to spray a wide area with shot and thus kill birds and small animals too difficult to hit with single-missile weapons. As the popularity of shotguns grew, ammunition was developed for large game. The use of shotguns on humans has been markedly increasing in various manner of death. In forensic aspect, the shotgun wounds have characteristic findings due to their own characteristics and medical examiners may determine the range, distance, direction and kinds of gun. When the muzzle of the shotgun is placed tightly against the surface of the abdomen or thorax, the consequent wound of entrance will be single in number and circular in shape, and will have a diameter approximately equal to that of the bore of the weapon. However, when the wound is made over a site with underlying bone, especially in the scalp, the wound may have a different appearance, showing star shaped entrance due to tears from the sides of the wound and accompanying soot and burn effect. When the muzzle is held short to mid-range, considerable variation occurs in the appearance of the wound. We report two cases of shotgun wounds which showed typical findings of contact shots and distant shots.
Subject(s)
Animals , Humans , Abdomen , Birds , Burns , Coroners and Medical Examiners , Firearms , Scalp , Soot , Thorax , Weapons , Wounds and InjuriesABSTRACT
Shotgun injury compared to gunshot injury has been reported to have tendency to make less severe damage due to its characteristic low velocity and fragmentation. Recently, we encountered with a patient who survived from shotgun injury. She shot herself for the purpose of suicide with a hunting gun. The multiple fragmented bullet particles were found on the nasal septum, inferior turbinate, near the sphenoid sinus, and especially in the esophagus. They were removed safely with nasal endoscope, C-arm, and esophagoscope. We report this case with review of literature.