A case of gunshot wound due to a shotgun causing multiple wounds is reported.
A 63-year-old man was accidentally shot by a shotgun at close quarters. A total of 23shots were noted in the head, chest, abdomen, and right thigh. Chest CT scan confirmed that some shots were present in the right lung and right ventricle. Under local anesthesia, one shot on the surface of the abdominal wall was extirpated. And others were removed using fluoroscopy under general anesthesia after his general condition was improved. Shots in the right lower extremety were present in the wall of superficial femoral artery, and the artery was reconstructed after removal of the shots. Shots in the right lung were spontaneously evacuated with sputa. The ramaining five shots in the mandibula, superior mediastinum, and right venticular wall were under clinical observation without removal. In order to remove shots, fuluoroscopy is useful and angiography to grasp the anatomical correlation between the shots and vessels is important to select appropriate therapy. Further, shots in portions where we have difficulty in removing them would often present no paticular problems, and saturmism is hardly induced by remained shots beneath the skin or in the muscule. However, saturnism has been reportedly caused by shots which remained in the body for more than 10 years, and hence, a careful long-term observation would be demanded.