An, otherwise, healthy 45 year-old male presented after sustaining an accidental shotgun trauma of the abdomen. It was a close-range injury. The entry wound was at the umbilical region. The patient was under hemodynamic instability. His heart rate was 122 beats per minute and his systolic blood pressure was 95 mmHg. He was tachypneic and had impaired mental status. During fluid resuscitation, the patient was immediately prepared for a diagnostic laparotomy. At the laparotomy, he was noted to have several injuries that included rapture of the rectus abdominis and deep fascia, a laceration of right hepatic lobe, a perforated gallbladder, a small non-expanding right-sided retroperitoneal haematoma, a total transection of the ascending colon near to hepatic flexure, several perforations of the ascending colon and of the proximal part of the transverse colon, a total transection of the most distal part of small intestine with large contamination and a bleeding laceration of the adjacent mesentery. Figure shows an x-ray of the abdomen, where the intra-abdominal pellets scatter is compatible with the intraoperative findings. The surgical repairs included hepatorrhaphy and use of topical haemostatic agent, right colectomy and anastomosis of the ileum with the transverse colon and open cholocystectomy. The peritoneal cavity was irrigated with warmed normal saline and drainaged, and the abdominal wall was completely closured. The intraoperative transfusion requirements were 6 units of packed red blood cells and 3 units of fresh frozen plasma. After the operation, the patient was admitted in the intensive care unit (ICU). The 4th postoperative day he was transferred out of the ICU. His total in-hospital stay was 18 days. One year later, the patient was admitted to hospital in order to undergo an elective operation for an abdominal wall hernia repair. He was discharged the 6th postoperative day.