Case Records of the Massachusetts General Hospital: A 37-year-old man was admitted to the surgical ICU because of a self-inflicted #gunshotwound to the face. Figure 2: #ctscan of the Face. A 3D reconstruction of the face (Panel A) shows the #entrywound in the submental region, the estimated trajectory of the #bullet (red arrow), and the #exitwound in the middle of the face. A 3D reconstruction of the facial bones (Panel B) shows loss of the mandibular symphysis, left mandibular parasymphysis, anterior maxillary alveolar ridge, and anterior nasal aperture. Another 3D reconstruction of the facial bones (Panel C) shows scattered bullet fragments along the wound, extending into the paranasal sinuses and right orbit. An axial image (Panel D) shows scattered bullet and bone fragments in the nasal aspect of the right orbit; these acted as secondary projectiles and caused rupture of the globe of the right eye. Coronal images (Panels E and F) show severe comminution of the bones of the middle of the face, with bone fractures extending to the intracranial compartment through the cribriform plate of the ethmoid sinus (Panel E) and the right frontal sinus (Panel F). Visit the link in our bio to read the case details and the management decisions that were made. #surgery #depression #trauma #primarycare #clinicalpractice #medical #meded #medicalscience #medicaleducation #gunviolence #gunshot #intensivecare