Skip to main content

Advertisement

Log in

Incidental occult gunshot wound detected by postmortem computed tomography

  • Case Report
  • Published:
Forensic Science, Medicine, and Pathology Aims and scope Submit manuscript

Abstract

The body of a 59 year old woman underwent postmortem computed tomography (PMCT) examination prior to forensic autopsy, using a 256 slice multidetector row computed tomography scanner. A large left tension pneumothorax detected on the PMCT was considered to be a likely cause of death and this was confirmed at autopsy. In addition there was an unsuspected PMCT finding of a probable gunshot injury traversing the right orbit, facial bones and frontal sinus. The autopsy technique was adjusted accordingly and PMCT findings confirmed. PMCT in this case was not only diagnostic of cause of death, but also revealed retained projectile fragments of an old gunshot wound to the face. Without prior imaging such findings would have been undetected at autopsy. This case further underscores the contribution of routine PMCT examination to forensic autopsy practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Thali MJ, Dirnhofer R, Vock P. The virtopsy approach. 3D optical and radiological scanning and reconstruction in forensic medicine. Boca Raton: Taylor and Francis Group, LLC; 2009.

    Book  Google Scholar 

  2. Thali MJ, Viner MD, Brogdon BG. Brogdon’s forensic radiology. 2nd ed. Boca Raton: Taylor and Francis Group, LLC; 2011.

    Google Scholar 

  3. Levy AD, Abbott RM, Mallak CT, Getz JM, Harcke HT, Champion HR, Pearse LA. Virtual autopsy: preliminary experience in high-velocity gunshot wound victims. Radiology. 2006;240:522–8.

    Article  PubMed  Google Scholar 

  4. Thali MJ, Yen K, Vock P, Ozdoba C, Kneubuehl BP, Sonnenschein M, Dirnhofer R. Image-guided virtual autopsy findings of gunshot victims performed with multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) and subsequent correlation between radiology and autopsy findings. Forensic Sci Int. 2003;138:8–16.

    Article  PubMed  Google Scholar 

  5. Berens S, Ketterer T, Kneubuehl BP, Thali MJ, Ross S, Bolliger SA. A case of homicidal intraoral gunshot and review of the literature. Forensic Sci Med Pathol. 2011;7:209–12.

    Article  PubMed  Google Scholar 

  6. Ruder TD, Ross S, Preiss U, Thali MJ. Minimally invasive post mortem CT-angiography in a case involving a gunshot wound. Leg Med (Tokyo). 2010;12:154–6.

    Article  Google Scholar 

  7. Sano R, Hirawasa S, Kobayashi S, Shimada T, Awata S, Takei H, Otake H, Takahashi K, Takahashi Y, Kominato Y. Use of postmortem computed tomography to reveal an intraoral gunshot injuries in a charred body. Leg Med (Tokyo). 2011;13:286–8.

    Article  Google Scholar 

  8. Stein KM, Bahner ML, Merkel J, Ain S, Mattern R. Detection of gunshot residues in routine CTs. Int J Legal Med. 2000;114:15–8.

    Article  PubMed  CAS  Google Scholar 

  9. Oehmichen M, Meissner C, König HG, Gehl HB. Gunshot injuries to the head and brain caused by low-velocity handguns and rifles. A review. Forensic Sci Int. 2004;146:111–20.

    PubMed  CAS  Google Scholar 

  10. Bolliger SA, Thali MJ, Ross S, Buck U, Naether S, Vock P. Virtual autopsy using imaging: bridging radiologic and forensic sciences. A review of the virtopsy and similar projects. Eur Radiol. 2008;18:273–82.

    Article  PubMed  Google Scholar 

  11. Baumann MH. Pneumothorax. Semin Respir Crit Care Med. 2001;22:647–56.

    Article  PubMed  CAS  Google Scholar 

  12. Haynes D, Baumann MH. Pleural controversy: aetiology of pneumothorax. Respirology. 2011;16:604–10.

    Article  PubMed  Google Scholar 

  13. Cheng YL, Huang TW, Lin CK, Lee SC, Tzao C, Chen JC, Chang H. The impact of smoking in primary spontaneous pneumothorax. J Thorac Cardiovasc Surg. 2009;138:192–5.

    Article  PubMed  Google Scholar 

  14. Bense L, Eklund G, Wiman LG. Smoking and the increased risk of contracting spontaneous pneumothorax. Chest. 1987;92:1009–12.

    Article  PubMed  CAS  Google Scholar 

  15. Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D. Epidemiology of pneumothorax in England. Thorax. 2000;55:666–71.

    Article  PubMed  CAS  Google Scholar 

  16. Cha JG, Kim DH, Kim DH, Paik SH, Park JS, Park SJ, Lee HK, Hong HS, Choi DL, Yang KM, Chung NE, Lee BW, Seo JS. Utility of postmortem autopsy via whole-body imaging: initial observations comparing MDCT and 3.0 T MRI findings with autopsy findings. Korean J Radiol. 2010;11:395–406.

    Article  PubMed  Google Scholar 

  17. Saukko P, Knight B. Knight’s forensic pathology. 3rd ed. London: Edward Arnold; 2004.

    Google Scholar 

  18. Christiansen LR, Collins KA. Natural death in the forensic setting. A study and approach to the autopsy. Am J Forensic Med Pathol. 2007;28:20–3.

    Article  PubMed  Google Scholar 

  19. Kurosaki K, Fushimi Y, Hara S, Kano S, Kuriiwa F, Nagai T, Endo T. Sudden death caused by tension pneumothorax after rupture of a thoracic aortic aneurysm case report. Am J Forensic Med Pathol. 2001;22:250–2.

    Article  PubMed  CAS  Google Scholar 

  20. Iwadate K, Ito H, Katsumura S, Matsuyama N, Sato K, Yonemura I, Ito Y. An autopsy case of bilateral tension pneumothorax after acupuncture. Leg Med (Tokyo). 2003;5:170–4.

    Article  Google Scholar 

  21. Leth PM. Computerized tomography used as a routine procedure at postmortem investigations. Am J Forensic Med Pathol. 2009;30:219–22.

    Article  PubMed  Google Scholar 

  22. Kühnel TV, Tudor C, Neukam FW, Nkenke E, Stockmann P. Air gun pellet remaining in the maxillary sinus for 50 years: a relevant risk factor for the patient? Int J Oral Maxillofac Surg. 2010;39:407–11.

    Article  PubMed  Google Scholar 

  23. Wenham K, Craig S, Tsitrou E. The incidental finding of a retained gunshot pellet. Dent Update. 2009;36:28–30.

    PubMed  Google Scholar 

  24. Navarro JA, Cortés E, Sanz CL, Pellicer MA. Finding of a bullet in the cervical column of a body hit by a train. J Forensic Sci. 1991;36:602–6.

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Gary Hatch for his significant contribution to the preparation of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Garyfalia Ampanozi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ampanozi, G., Schwendener, N., Krauskopf, A. et al. Incidental occult gunshot wound detected by postmortem computed tomography. Forensic Sci Med Pathol 9, 68–72 (2013). https://doi.org/10.1007/s12024-012-9369-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12024-012-9369-3

Keywords

Navigation