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A novel technique to locate subcutaneous shotgun projectiles.

BACKGROUND In the UK, shotgun injuries are rare but increasing. The degree of ballistic induced, soft tissue injury is related to kinetic energy transfer. The low muzzle velocity, coupled with projectile dispersion after ejection from the barrel, means that the kinetic energy of each projectile from a shotgun cartridge is low, often producing penetrating rather than perforating wounds. Distant range gunshot injuries produce multiple entry wounds containing shot, small amounts of soot and powder (Fig 1). Owing to the risk of infection, local tissue damage and implantation of foreign material, projectiles are often removed and their tracks irrigated. Dictated by its energy, entry angle and tissue density, the resting position of the projectile is often distant from the visible entry point. Locating the shot may be challenging, necessitating radiological assistance. Multiple projectiles may require considerable exposure. Figure 1 Sterile, saline soaked, gauze swabs wrapped around a 500ml pre-frozen, sterile fluid bag