Introduction: This study aimed to determine the types of trauma inflicted on different areas of the body as a result of shotgun injuries, while also evaluating the diagnostic and therapeutic interventions performed.
Method: This was a descriptive-analytical cross-sectional study conducted on individuals injured by a shotgun during the 2022 unrest in Tehran. A total of 180 individuals were included. Injured individuals were categorized into police or security and protester groups and compared in terms of type of injury and severity. Data were collected from hospital records, including demographic information, injured body areas, trauma-related complications, and diagnostic and therapeutic measures. The Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS) were calculated based on available data. Statistical analysis was performed using SPSS software.
Result: Out of 180 injured patients included in the study, 172 were male and eight were female. The mean age was 31.82 ± 11.47 years, ranging from 10 to 63 years. Among them, 106 were police or security personnel and 74 were protesters. The mean ISS for all patients was 1.48 ± 0.96. Comparison between the two groups showed that police or security personnel sustained more severe injuries (1.69 ± 1.24 vs. 1.18 ± 0.55; P = 0.01). Injuries to the head, face, neck, and chest were significantly more common among police or security personnel (P = 0.024), while abdominal, pelvic, and lower limb injuries were more prevalent among protesters (P = 0.015).  Imaging tools such as plain radiography and CT scans were used for diagnostic evaluation. All 21 cases of chest trauma were diagnosed by chest X-rays. Two cases required chest CT scans, which showed no lung or cardiac injury. In abdominal injuries, 51% of radiological assessments had positive findings. Among 40 cases of head and neck trauma, only one showed pellet penetration of the skull bone, and no brain tissue injury was observed. Regarding treatment, 42 patients (23.3%) required hospitalization, while 138 (76.7%) were treated on an outpatient basis. None required CPR or airway management.
Conclusion:  Shotgun pellets has not high energy and usually cause minor injury but sometime may cause serious injuries. Removal during early hospitalization is not recommended. Deep pellets in limbs generally do not require removal unless surgery is indicated due to vascular or neurological damage. Chest injuries with deep or multiple wounds require more radiographic study. Deep or multiple wounds in the abdomen need additional evaluation to rule out serious intra-abdominal injuries. Greater caution is needed in managing facial and neck injuries, necessitating more intensive care.