Craniofacial shotgun pellet injury

Case contributed by Dr Shailaja Muniraju

Presentation

Young gentleman caught in civil war. Suspected intraocular foreign body.

Patient Data

Age: 22
Gender: Male
Modality: X-ray

Approximately 15 radio-opaque foreign bodies noted in the craniofacial region. 

Modality: CT

Multiple metallic density foreign body densities are noted in the subcutaneous scalp tissues bilaterally consistent with multiple projectiles. Further intra-ocular densities as below:

  • Adjacent to the left middle turbinate.
  • Posterior sclera, just above the junction of left optic nerve with sclera (Superior quadrant).
  • Mid segment of left lateral rectus muscle.

No intracranial projectiles are seen. There is streak artifact due to beam hardening.

Special thanks : Dr. H K Anand

Case Discussion

This is a case of shotgun pellet injury. These guns are used for law enforcement by police forces. 

In such cases, the primary objective of the radiologist is to identify the projectile path, anatomic distribution and the presence of any associated acute injury.

For further MRI imaging, utmost care should be taken - due to possible ferromagnetic nature of the pellets.

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Case Information

rID: 48755
Case created: 22nd Oct 2016
Last edited: 21st Nov 2016
Inclusion in quiz mode: Included

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