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Spain. Middle facial injury with cranial rupture caused by shotgun blast. No further info. Despite the extreme amount of cranial destruction, careful and meticulous reapproximation of the calvarium, scalp, and facial tears allows for the demonstration and confirmation of a frontal entrance wound. Reconstruction of the wound can be very important to determine particular wound characteristics in cases of alleged homicide.

Fig.1 Shotgun blast to the head.

In the head, neck, and limbs, shotgun exit wounds can be ragged and very large, with extensive tissue damage. In a suicide where the gun has been placed in the mouth, there will be significant disruption of the head, and brain may be expelled, the so-called “burst head” effect.

Fig.2 Facial tears.

At close range, the shotgun is the most formidable and destructive of all small arms. For birdshot and buckshot loads, the severity and lethality of a shotgun wound depends on the number of pellets that enter the body, the organs struck by the pellets, and the amount of tissue destruction. Typically, these wounds are jagged, irregular lacerations with everted edges and bone fragments under the skin.

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