Role of Maxillofacial Radiologist in Ballistic Wound: Case Report with Literature Review


Gunshot injuries are rather serious but uncommon type of trauma in India. Radiologists can contribute substantially in evaluation and treatment of patients with a gunshot wounds. Plain films, CT, Angiography, and sometimes MR imaging are used to localize shots. This paper describes a case report of shotgun injury to the face and neck and also attempts to illustrate the spectrum of available imaging with relevant findings pertaining to bullets and shotgun pellets in gunshot injuries. Radiologists should be aware of the associated complications and forensic implications when they take on the task of interpreting these images.

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N. Sultana and E. Sham, "Role of Maxillofacial Radiologist in Ballistic Wound: Case Report with Literature Review," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 1 No. 2, 2012, pp. 34-38. doi: 10.4236/ijohns.2012.12007.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. L. Amnest, J. A. Mercy and G. W. Ryan, “Surveillance Gotsch Fatal and Nonfatal of FirearmsRelated Injuries—United States, 19931998,” MMWR Morb Mortal Wkly Rep., 2001.
[2] “The Seventh United Nations Survey on Crime Trends and the Operations of Criminal Justice Systems (19982000),” United Nations Office on Drugs and Crime (UNODC).
[3] D. Demetriades, S. Chahwan, H. Gomez, A. Falabella, G. Velmahos and D. Yamashita, “Initial Evaluation and Management of Gunshot Wounds to the Face,” Journal of TraumaInjury Infection & Critical Care, Vol. 45, No. 1, 1998, pp. 3941. doi:10.1097/0000537319980700000007
[4] D. Puzovic, V. S Konstatinovic and M. Dimitrijevic, “Evaluation of Maxillofacial Weapon Injury: 15Year Experience in Belgrade,” Journal of Craniofacial Surgery, Vol. 15, No. 4, 2004, pp. 543546. doi:10.1097/0000166520040700000003
[5] A. Cowey, P. Mitchell, I. Gregory, I. Maclennen and R. Pearson, “A Review of 187 Gunshot Wound Admissions to a Teaching Hospital over 54Month Period: Training and Service Implications,” Annals of the Royal College of Surgeons of England, Vol. 86, No. 2, 2004, pp. 104107. doi:10.1308/003588404322827482
[6] L. Cunninghum, R. Hough and J. Ford, “Firearm Injuries to the Maxillofacial Region: An Overview of Correct Thoughts Regarding Demographics, Pathophysiology and Management,” Journal of Oral and Maxillofacial Surgery, Vol. 65, No. 8, 2003, pp. 932942. doi:10.1016/S02782391(03)002933
[7] K. Sansare, V. Khanna and F. Karjodkar, “The Role of Maxillofacial Radiologists in Gunshot Injuries: A Hypothesized Missile Trajectory in Two Case Reports,” Dentomaxillofacial Radiology, Vol. 40, No. 1, 2011, pp. 5359. doi:10.1259/dmfr/72527764
[8] A. J. Wilson, “Gunshot Injuries: What Does a Radiologist Need to Know? Imaging Symposium,” Radio Graphics, Vol. 19, No. 5, 1999, pp. 13591368.
[9] K. G. Swan and R. C. Swan, “Principles of Ballistics Applicable to the Treatment of Gunshot Wounds,” The Surgical Clinics of North America, Vol. 71, No. 2, 1991, pp. 221239.
[10] C. H. Choi, J. Pritchard and J. Richard, “Path of Bullet and Injuries Determined by Radiography,” American Journal of Forensic Medicine & Pathology, Vol. 11, No. 3, 1990, pp. 240245.
[11] C. D. Phillips, “Emergent Radiologic Evaluation of the Gunshot Wound Victim,” The Radiologic Clinics of North America, Vol. 30, No. 2, 1992, pp. 307324.
[12] Y. H. Tan, S. X. Zhou and Y. Q. Liu, “SmallVessel Pathology and Anastomosis Following Maxillofacial Firearm Wounds: An Experimental Study,” Journal of Oral and Maxillofacial Surgery, Vol. 49, No. 4, 1991, pp. 348352. doi:10.1016/02782391(91)90368V
[13] M. Oehmichen, C. Meissner and H. G. K?nig, “Brain Injury after Gunshot Wounding: Morphometric Analysis of Cell Destruction Caused by Temporary Cavitation,” Journal of Neurotrauma, Vol. 17, No. 2, 2000, pp. 155162. doi:10.1089/neu.2000.17.155
[14] J. A. Glezer, G. Minard, M. A. Croce, T. C. Fabian and K. A. Kudsk, “Shotgun Wounds to the Abdomen,” The American Surgeon, Vol. 59, No. 2, 1993, pp. 129132.
[15] M. Can, N. Yildirin and K. G. Atore, “Dissecting Firearm Injury to the Head and Neck with NonLinear Bullet Trajectory: A Case Report,” Forensic Science International, Vol. 197, No. 1, 2010, pp. e13e17. doi:10.1016/j.forsciint.2009.12.050
[16] N. A. Ebraheim, E. R. Savolaine, W. T. Jackson, T. G. Andreshak and A. Aayport, “Magnetic Resonance Imaging in the Evaluation of a Gunshot Wound to the Cervical Spine,” Journal of Orthopaedic Trauma, Vol. 3, No. 1, 1989, pp. 1922. doi:10.1097/0000513119890301000004
[17] W. C. Hanigan, A. M. Wright, W. A. Berkman and T. E. Szymke, “MR Imaging of a False Carotid Aneurysm,” Stroke, Vol. 17, No. 6, 1986, pp. 13171319. doi:10.1161/01.STR.17.6.1317
[18] C. J. Fox, D. L. Gillespie, M. A. Weber, et al., “Delayed Evaluation of CombatRelated Penetrating Neck Trauma,” Journal of Vascular Surgery, Vol. 44, No. 1, 2006, pp. 8693. doi:10.1016/j.jvs.2006.02.058
[19] D. Demetriades, D. Theodorou, E. Cornwell, et al., “Penetrating Injuries of the Neck in Stable Patients: Physical Examination, Angiography or Colour Flow Doppler Imaging,” Archives of Surgery, Vol. 130, No. 9, 1995, pp. 971975. doi:10.1001/archsurg.1995.01430090057019
[20] T. R. Bonk, D. S. Harisson and H. M. Meissner, “Intravascular Bullet Localization by Sonography,” American Journal of Roentgenology, Vol. 167, No. 1, 1996, pp. 151152.
[21] A. Ramasamy, D. E. Hinsley and A. J. Brooks, “The Use of Improvised Bullet Markers with 3D CT Reconstruction in the Evaluation of Penetrating Trauma,” Journal of the Royal Army Medical Corps, Vol. 154, No. 4, 2008, pp. 239241.
[22] R. H. Hough, “Gunshot Wounds to the Head and Neck,” In: J. P. W. Kelly, Ed., Oral and Maxillofacial Surgery. Knowledge Update, American Association of Oral and Maxillofacial Surgeons, Chicago, 1995, pp. 6568.

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