Shotgun wound to the head

This individual has a 12 gauge single-shot shotgun wound to the side of the head. Found supine on snow, with end of barrel held in left hand. He was suffering from depression.

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The head is the most common location for a suicidal shotgun wound (74%), followed by the chest (20%) and then the abdomen (6%). In head wounds, the most common location was intraoral (50%), followed by under the chin (19%); side of head, including parietal and temporal wounds (15%); and the face, including the forehead (13%).

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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. Head injuries from shotguns and high-powered rifles are typically quite devastating, often with extensive soft tissue destruction, skull fractures, and pulpifaction of the brain. Occasionally, the brain is largely expelled from the cranial vault and may be found near the body.

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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.