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.     

Expert evaluation of the gunshot distance based on the volume of wound canal in flat bones

Different-distance experimental shots were made from a rifled gun at flat bones. Those shot distances were established, at which the wound canal had the smallest volume, and, at which entry and exit holes were virtually identical and matched the bullet diameter. A bigger shot distance was associated with an increasing volume of the wound canal caused by a bigger exit hole. A smaller shot distance led, also, to an increasing volume of the wound canal caused by bigger entry and exit holes. The volume of the wound canal in flat bones can be used as a reliable criterion in assessing the shot distance.     

Behavior of expelled glass fragments during projectile penetration and perforation of glass

Bullets striking common forms of flat glass with an orthogonal intercept angle result in a cloud of ejected glass fragments that are in concert with the exiting bullet's flight path. This is not the case with strikes at angles other than orthogonal. In these situations, the expelled glass fragments follow a very different course from that of the exiting projectile. This is both counterintuitive and a potential source of serious error in the evaluation and reconstruction of a shooting victim's position and orientation at the moment the victim was struck by a bullet that has passed through a nearby source of glass such as a vehicle side window or a window in a building. The flight path of the ejected glass fragments is, however, predictable and is dictated by the orientation of the plane of the glass opposite the projectile's impact site.In all cases, these expelled glass particles have considerable velocity and can produce pseudostippling of the skin in individuals located downrange of bullet-struck glass and near the projectile's exit site. The distribution and location of such pseudostippling and its relationship to the associated bullet hole in glass have important reconstructive value. A proper and reliable reconstruction of the victim's position in such cases will require the integration of scene information with the autopsy findings.     

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.     

Morphology of bullet wounds when using police ammunition, type QD-P.E.P

6 years after introduction of the police ammunition QD-P.E.P. (9 mm caliber), 9 bullet wounds are presented from forensic investigations along with the results of experimental shots at pig carcasses. The evaluation reveals the characteristic pattern of such bullet wounds: a skin defect which is almost as large as the caliber and has a sharp-edged border thus looking like it has been punched out; the contusion ring ("abrasion ring") is conspicuously narrow. These findings can be explained by the shape and design of the projectile. In regular police work immediate incapacitation has not always been achieved, depending on the entry location of the bullet. Experimental shots at pig carcasses showed that in the case of shots at extremities, the residual energy of the exiting bullet may be sufficient to generate another penetrating bullet wound.     

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.     

Preliminary investigation into the use of Micro-CT scanning on impact damage to fabric,tissue and bone caused by both round and flat nosed bullets

Firearm offences in the UK, though not as high as in the USA, are increasing year upon year within both countries (Office for National Statistics, 2018 & Mervosh, 2018). This preliminary study looked into using Micro-CT scanning as a method to visualise impact damage and spray patterns caused by 12 test firings of both round and flat nosed bullets to porcine bone (shoulder and leg) suspended in ballistic gelatine and left with no covering, covered with a skin substitute, or covered with fabric (cotton or denim). Micro-CT scanning alongside VG Studio Max showed that overall, in the case of the shoulder bones the round nosed produced longer spray patterns (35.37 mm) within the gelatine blocks compared to the flat nosed bullet (27.33 mm); while with the leg bones the spray patterns were shorter, round nosed bullet (15.64 mm) and the flat nosed bullet (20.78 mm). These initial results showed that both bullet types produced considerable damage, from splitting to full penetration, which in turn illustrates how Micro-CT scanning has benefits within forensic ballistics, which should be further investigated.     

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.     

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。     

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.     

Wounds caused by contact with muzzle-lift relief ports (Mag-Na-Port).

Fan-shaped stippled burns were produced on the skin when a revolver whose barrel had been modified by the Mag-Na-Port process was fired twice with the side of the muzzle in contact. A grazing wound was produced by one bullet, and an oblique entry was produced by the other. The characteristics of Mag-Na-Port wounds and test shots are described, and these are compared with test shots from two other higher power revolvers.     

Gunshot reconstructions based on individually parametrical 3-dimensional victim models]

In cases of lethal firearm injuries computer enhanced anatomical feasibility studies can provide unambiguous clues concerning self-versus extraneous infliction. To this end individualized digital 3-dimensional geometrical models of the victim and the weapon are generated true to scale with the help of the CAD software (POSER Version 4, egi.sys AG). All anatomical data relevant to the motion apparatus and the range of movement as well as the injuries of the individual victim are carefully documented and serve as input parameters for the digital geometrical model. The bullet path is visualized as a cylinder between entrance and exit wound. A series of simulation sequences then can be carried out by the variation of anatomically possible shot positions and the virtual grasp of the weapon. An exact alignment of the firearm's barrel and the bullet path is a reliable statement for the feasibility of self-infliction. In addition to circumstantial evidence the digital reconstruction of the firearm shot admits of unambiguous conclusions about the course of the traumatic event.     

A shot through the window

At issue in this case was whether an unusual window defect seen in two of the crime scene photographs was due to a bullet and if so, if that same bullet fatally wounded the victim. The window appeared to have been cracked prior to the apparent shot through it. A .22 bullet recovered from autopsy, when examined only by light microscopy, failed to show associated glass fragments. A previously cracked test window was shot a number of times with .22 caliber bullets near the cracks in an effort to simulate the window defect seen in the crime scene photographs. Several of the defects produced by the test window shots appeared similar to the crime scene window defect. The .22 bullet taken from the victim and several of the test bullets (collected by a cotton box) were examined by scanning electron microscopy/energy dispersive X-ray spectroscopy. The test bullets showed glass particles on and embedded in their surfaces. Particles of similar size and composition were found embedded in the surface of the bullet from the victim. The bullet likely struck the window prior to hitting the victim. It was apparent by the morphology of some of the mushroomed test .22 bullets that they hit the window crack. These bullets showed that the glass on one side of a crack often fails before the other side during the strike. Aggregations of powdered glass on many of the mushroomed surfaces of the .22 bullets suggest that as the bullet mushrooms during impact on the window surface, the glass in contact with the bullet powderizes and coats the mushroomed surface of the bullet with a layer of fine glass particles.     

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。     

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.