Concordance Rate for the Identification of Distant Entrance Gunshot Wounds of the Back by Experienced Forensic Pathologists Examining Only Images of Autopsies

The images of 66 gunshot entrance wounds with a defect on the back, a bullet in the body, hemorrhage along the wound track, and logical certainty that it was an entrance wound were collected from the files of a moderately busy medical examiner's office. Participants numbering 22 board‐certified forensic pathologists viewed a single digital archival image of each of the 66 entrance wounds randomly mixed with 74 presumptive exit wounds to determine whether they were entrance or exit wounds. The concordance rate for correctly identifying the 66 logically known entrance wounds was 82.8% with a range from 58% to 97%. This pilot study was conducted to provide an evidence‐based approach to the interpretation of the direction of gunshot wounds by reviewing pathologists with access only to archival photographs, and it is not a measure of the accuracy to distinguish entrance from exit wounds when given all of the circumstances.     

Upon a failure to equal entry and exit wounds: a possible case of tandem bullets in view of the literature

Forensic medicine specialists take account of the projectiles remaining in the body when determining whether there are an equal number of entry and exit wounds. The absence of projectiles should suggest blank cartridges, a single exit wound despite several firings and bullet embolization, whereas the presence of more projectiles than expected may indicate tandem projectiles and multiple projectiles entering through the same hole. Radiological examination of the whole body, follow-up of the bullet trajectories, examination of the clothes, and examination of the gun and projectiles play a key role in solving difficult cases. We review such situations based on a case of tandem bullets. Two 7.65-mm bullets created lethal wounds entering through a 32-year-old victim's neck followed the same trajectory to a certain point and diverted. We discussed the possibilities in cases that show inequalities between entry and exit wounds, in light of relevant literature.     

Cranial fracture patterns and estimate of direction from low velocity gunshot wounds

Cranial trauma produced by low velocity gunshot wounds is investigated in an autopsy series. In skeletonized remains with postmortem damage, or after surgical debridement, the primary internal or external beveling may become obscured, causing difficulty with the identification of entrance and exit wounds. The morphology of associated secondary and tertiary fractures based upon the mechanics of their production is discussed as a means of establishing bullet entrance and exit sites.     

Shored gunshot wound of exit. A phenomenon with identity crisis

Shored gunshot wound of exit is produced when the outstretched skin is impaled, sandwiched, and crushed between the outgoing bullet and the unyielding object over the exit site, thus leaving an abrasion collar on the wound margin. Proper coaptation of the wound margin is impossible because of the loss of skin just like those observed in entrance wounds. In contrast to the entrance wound, the supported exit wound shows a scalloped or punched-out abrasion collar and sharply contoured skin in between the radiating skin lacerations marginating the abrasion (Fig. 1). Should gunpowder be observed around the exit site, it is often unevenly distributed, and is not associated with searing, gunpowder stippled abrasion, tatooing, and deposition of soot.     

Pump-gun as a weapon. Type of injuries, prohibition of weapons

Pumpguns are shotguns with pump action whose injuries and wound mechanisms have several special features: extremely high kinetic energy of the shot (2500 to 3500 J) frequent cases of "Kr?nlein shots" (exenteration of the brain) punchmark/imprint immediately adjacent to the entrance wound from the front of the pipe magazine exit wounds from buckshot may be similar to pellet entrance injuries from a distant shotgun discharge the use of various shotgun cartridges (plastic ammunition, slug bullet, various lead pellets) within the same weapon. The change in the Austrian gun law and the banning of the pumpgun in 1995 is also discussed in the article.     

Characteristics of gunshot wounds in the skull.

The analysis of trauma to the skeleton is an important aspect of forensic case work, but most pathology references devote limited attention to this topic. This paper describes various aspects of gunshot wounds, including entrance and exit patterns, angle and path, range of fire and velocity, and caliber of the bullet, based on observations of a series of known cases. Skeletal remains of 21 victims of gunshot wounds were studied. In most cases, there was documentation of the investigation, autopsy, and victim's identity. Each case was analyzed in terms of wound location, shape, size and exit/entry surface area ratio, beveling, and direction of shooting Skull entry wounds were most often round or oval. Unusual shapes were observed in bones like the mandible and mastoid process, but were also found to be triangular, nearly rectangular or irregular. Tunneling was observed in the mastoid process. The expected internal beveling was obvious in all but one skull. External beveling of an entry wound was only observed in one case (parietal bone). Exit wounds were roughly round, oval, square, and rectangular and were always more irregular than entry wounds. External beveling of exit wounds was observed in most vault bones, but there was none in the orbit, maxilla, greater wing of the sphenoid, temporal, or left occipital bone. Tangential gunshot wounds were seen in a mastoid process, zygomatic process, mandibular ramus and condyle, and occipital condyle. Most of the exit to entry surface area ratios (cm2) varied from 1.4 to 2.0. In four cases the ratio indicated that entrances were larger than exists. In conclusion, understanding of gunshot wound characteristics is an important matter to interpret distance, velocity, direction and sometimes caliber size. Assessment of this nature of gunshot wounds helps reconstruct events surrounding the death.     

枪弹创后置物射出口形态学的实验研究

为建立后置物射出口与射入口的检验鉴定方法，使用国产五四式7．62mm口径手枪及五六式7．62mm口径半自动步枪，以5米的距离射击约克夏种白猪18只，同时以木板、水泥板、玻璃及衣服等作为射出口衬垫物，制成后置物射出口56例，并与对照组12例射出口进行对比观察。结果表明，射出口与后置物距离在3cm以内均可出现创缘伸展轮及皮下出血，且与后置物质地及距离成正比。根据其形态分为典型及非典型两类，并建立了此类射出口的检验方法及其与射入口鉴别的依据，有助于法医在实际检验中对射击方向的判断。     

Postmortem Computed Tomography and Magnetic Resonance Imaging of Gunshot Wounds to the Neck

Postmortem magnetic resonance imaging (MRI) is rarely used for the radiologic assessment of gunshot injuries, although it has clear advantages over postmortem computed tomography (CT) with regard to the imaging of soft tissue injuries. Another benefit in using MRI is that lodged projectiles composed of nonferromagnetic material such as lead present only marginal metal artifacts compared with severe artifacts on CT. This case report presents CT and MRI findings in a case with two gunshot wounds to the neck: a perforating wound and a nonperforating wound with a lead bullet lodged in the cervical spine. The decedent underwent CT and MRI before the scheduled autopsy. A ring of radiopaque material under the dermis in the fatty tissue was identified at both entrance wounds on CT, which was indicative of contact shots. The perforating gunshot was clearly indicated on CT by bullet fragments along the wound channel through the perforated 6th cervical vertebra and the fractured cricoid cartilage at the exit wound. The second trajectory, however, was only assumed based on the presence of gunshot residues at the entrance wound and the position of the lodged bullet. The radiologic assessment was severely impeded by the metal artifacts on CT. Barely noticeable metal artifacts on MRI allowed for clear visualization of the soft tissue injuries and the ruptured medulla oblongata. Only MRI clarified the soft tissue injuries of the brainstem noninvasively, which could provide specific and graphic information on the rapidity of death and the incapacitation of the victim.     

Improved method for shooting distance estimation. Part III. Bullet holes in cadavers

An improved method to estimate firing distance on human body surfaces is described. The novel part of the method includes a chemical test in addition to the traditional visual and microscopic examinations of the gunshot wounds. This chemical test consists of a transfer of the gunpowder residues from the area of a gunshot wound to an adhesive lifter; the residues are then visualized as total nitrite after alkaline hydrolysis by the Modified Griess Test (MGT). When cadavers are in an advanced stage of decomposition or when gunshot wounds are in hairy areas, the information obtained by this chemical test can be crucial for shooting distance evaluation. In other cases it may improve the accuracy of the examination. In some cases, the results obtained by this test may assist in the discrimination between entrance and exit gunshot wounds.     

A case of internal beveling with an exit gunshot wound to the skull

Exit gunshot wounds of the skull generally have external beveling while entrance wounds show internal beveling. With rare exceptions, entrance gunshot wounds show external beveling, usually of two types: the asymmetric ‘keyhole’ type and the symmetric ‘non-keyhole’ type. In exit gunshot wounds of the skull, only the keyhole type has been reported. This report shows that symmetric internal beveling from an exit gunshot wound to the skull may confuse medical personnel.     

Discordance of Gross and Histologic Findings in Estimating the Range of Fire of Gunshot Wounds

Forensic pathologist use soot and/or stippling surrounding entrance gunshot wounds in categorizing range of fire. If absent, some pathologists suggest utilizing histology when the range is diagnostically critical. This study investigates the concordance of macroscopic and microscopic findings in estimating range of fire by evaluating gunshot entrance and exit wounds made through human tissue analogs at defined distances using two handgun calibers. Examination of over 150 entrance wounds verified the ease of visually detecting soot from a muzzle distance of contact to 1 foot (30.5 cm), and its absence at 9 feet (274.3 cm). Distinctly apparent was bullet wipe surrounding the entrance wounds regardless of muzzle distance. Although variations existed, dark material was histologically identified in many skin, soft tissue, and bone sections at all ranges with both calibers. These nonparallel results decrease the dependability of histology for range of fire estimation and reinforce using gross observation.     

Analysis of beveling in gunshot entrance wounds

The analysis of skeletal trauma is an important aspect of forensic case work. Yet most major pathology references devote limited attention to this topic. The aim of this paper is to analyze beveling in gunshot entrance wounds, from a series of 27 cases with a total of 39 wounds. Assessment was made by measuring the external and internal cranial dimensions, describing the area of most pronounced beveling, and correlating the directions of the beveling with the trajectory of the bullet. Results indicated that inward beveling was found in 36 of 39 cases, the absence of beveling in four bones, and actual external beveling in one case. The inconsistency in the direction of most pronounced beveling in reference to the direction of shooting leads to the conclusion that this characteristic cannot be used to make a reliable assessment of the direction of fire.     

Path of bullet and injuries determined by radiography

Radiography is commonly used to find bullet pathways in forensic pathology. In the case presented here, a man had sustained multiple gunshot wounds and one bullet could not be traced. A radiograph was used to find the bullet and showed an interesting bullet pathway. By observing the bullet pathway on a radiograph, sometimes we can surmise the victim's body posture at the time of an incident.     

Confusing injury findings in a suicidal gunshot fired to the chest from a carbine with a sawed-off barrel

The stellate bullet entrance wound is one of the facultative features of a contact shot. For the formation of a star-shaped wound two factors are of special importance: first, an extensive bony support underlying the skin in the entrance region, and second, a strong propellant charge of the cartridge fired. Contact shots to the precordial region usually do not cause stellate entrance wounds, even if high-powered rifle ammunition is used. In the reported case, an injury pattern was observed that was not in line with normal findings and seemed confusing at first. Following a suicidal gunshot to the chest from a sawed-off carbine 98a (cal. 8 x 57 Js), a 4.5 cm wide, gaping bullet entrance wound with radiating tears was found. Instead of the usual pocket, the anterior thoracic wall showed a fist-sized area of destruction with extensive undermining of the subcutis. Not far from the entrance hole, a rib fragment had become displaced retrogradely thus perforating the skin from the inside out. The unusual pattern of findings could be explained by the fact that the barrel had been sawed off: as a result of this manipulation, a considerable part of the propellant charge had been converted outside the barrel, i.e. in the initial section of the bullet path.     

9mm警用转轮手枪橡胶弹射入口的形态特征

目的观察橡胶弹射人口的形态特征,并探讨其法医学意义。方法使用9mm警用转轮手枪发射橡胶弹,在实验动物胸腹部侧面垂直射击,射击距离分别为紧密接触射击（0cm）,相对接触射击（1～6cm）,近距离射击（6-60cm）和远距离射击（60cm～有效射程25m）。92式手枪采取相同方式射击实验动物作为对照。观察射入口的形态特征,制作组织病理学切片,HE染色显微镜下观察。结果橡胶弹接触射击和近距离射击,射入口边缘整齐,有明显的擦拭轮、挫伤轮和火药斑纹;远距离射击,可见射人口边缘撕裂,挫伤轮明显增宽,皮下出血显著;与手枪弹射入口形态特征明显不同。结论9mm警用转轮手枪橡胶弹射入口典型的形态特征,可作为此类损伤的诊断指标。     

Tumbling abrasions. Injuries from ricocheting bullets

Atypical entrance gunshot wounds may be produced by deflected or ricocheting bullets. One special type of atypical entrance wound involves abrasion of the skin at a site that is remote from the point of dermal penetration. These remote abrasions, termed "tumbling abrasions," are produced by bullets that tumble after impact with an intermediate target. Three cases of tumbling abrasions are presented.     

An Unusual Suicide Inside a Grave with Two Gunshot Wounds to the Head—The Psychological Approach

Abstract: In this report, the authors present a case of suicide committed by a 66-year-old man, inside a grave at the local cemetery, with two gunshot wounds to the head. A multiple-paged, handwritten suicide note was found in an army type bag inside the victim’s car, while a second one was found in his house. Medicolegal examination of the body revealed two typical contact gunshot entrance wounds and one exit wound to the head. Toxicological analysis of the femoral blood was negative for alcohol and drugs. The history, scene and autopsy findings, along with further police investigation, indicated an obvious case of suicide. The literature is reviewed and discussed. We report this case as the place of suicide is extremely uncommon and as there is no mention of a gunshot suicide inside a grave in the current literature.     

霰弹弹杯所致损伤及其应用价值

本文17例制式霰弹猎枪射入口和创道的病理形态学，通过结合射击实验获得了较为一致的结果。初步认为，商品霰弹中的塑料弹杯所造成射入口创缘或创周损伤的形态变化与射击距离密切相关，在法医学鉴定中具有一定的应用价值。