Kemper et al described the appearance of a shotgun wound on a CT scan. The authors are from the University of Washington Seattle and Harborview Medical Center.
The goal of the CT scan is to locate any wadding or other contaminants which might serve as a nidus of infection. These items may follow a different pathway from the bullet or pellets.
Indications for a CT scan to examine a shotgun wound:
(1) close range discharge, with the estimated distance between the shotgun and the victim < 2 meters (wadding is unlikely to enter the victim at a greater distance)
(2) radiolucent wadding (such as cardboard)
(3) presence of radiolucent wound contaminants (clothing, etc)
Additional indications (not listed by the authors):
(4) use of nonmetallic projectiles in a specialty shell
NOTE: The magnetic field of an MRI machine might attract the bullet fragments and so would not be indicated.
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