Intraoral 12-gauge shotgun wound to the head

Shotgun wounds impart a large amount of energy to the tissues, particularly if fired at contact or close range. In this intraoral 12-gauge shotgun wound, note the blowout and overall destruction of the top of the head. Contact range shotgun wounds of the head often produce devastating injuries with extensive tissue disruption. In these situations, it may seem impossible at first to determine where the entrance wound is located. However with careful and meticulous reapproximation of the tissues, the entrance wound and exit wound are often revealed.