Shotgun wounds involving the head and neck.

Since limited information is available on the management and spectrum of injuries sustained by patients with shotgun wounds to the head and neck, we reviewed the records of 26 patients with shotgun wounds involving the head and neck region. Fifty-four percent of these patients had associated injuries involving the trunk or extremities, and 43 percent of these patients required repair of these associated injuries. Overall, 23 percent of patients with shotgun wounds of the head and neck region had injuries of other anatomic areas that required operative treatment. In these patients, the major life-threatening injuries were not related to the head and neck region but were related to injuries of other anatomic areas. By stratifying the patients according to the anatomic pattern of injury (point blank, close range, or long range) and their hemodynamic status on presentation to the emergency room, it was possible to predict the need for surgery as well as the risk of death.