Practical Pathology of Gunshot Wounds

Archives of Pathology & Laboratory Medicine, Sep 2006 by Denton, J Scott, Segovia, Adrienne, Filkins, James A

PHOTOGRAPHING GUNSHOT WOUNDS

Proper photographic documentation of gunshotwounds is critical. The wound should be cleaned of excess blood and hair before being photographed. Thirty-five millimeter photographic or slide film is commonly used with digital photographs as a backup. The wound should be photographed both from a medium distance to indicate its location on the body in relation to easily recognizable body landmarks and from close-up to illustrate the characteristics of the wound.

COMMON PITFALLS

There are some common pitfalls or omissions that may occur in the examination and documentation of gunshot wounds. Evidence of contact range fire around the wound or clothing may be lost if the wound is cleaned or the surrounding hair is shaved to expose the wound prior to examination. All the clothing on or with the body should be examined for gunshot residue because clothing can absorb soot and stippling preventing it from reaching the skin around the wound. At a minimum, the clothing involved should be photographed, preserved, and submitted to the crime laboratory for examination and presentation at trial. In this modern age, fluoroscopy, radiographs, and occasionally computerized tomography are essential to document the location of projectiles within the body and help in their recovery. Finally, wounds should not be vigorously "probed" with metal rods, because this creates false tracks through the tissue confusing the true course of the wound.

CONCLUSION

There is an epidemic of gunshot wound fatalities nationwide. Interpretation, investigation, and adjudication of these deaths require dedicated and well-trained forensic pathologists. This brief, practical introduction to the complex topic of gunshot wound pathology has covered the basics of gunshot wound examination in forensic pathology while providing a glimpse into some of the more complex issues in evaluating these wounds.

References

1. Centers for Disease Control and Prevention. Nonfatal and fatal firearm-related injuries: United States, 1993-1997. MMWR Morb Mortal Wkly Rep. 1999; 48:1029-1034.

2. Volgas DA, Stannard JP, Alonso JE. Ballistics: a primer for the surgeon. Injury. 2005;36:373-379.

3. Bonfanti MS, de Kinder J. The influence of manufacturing processes on the identification of bullets and cartridge cases: a review of the literature. Sci Justice. 1999;39:3-10.

4. DiMaio VJM. Characteristics of rifles, handguns, and ammunition. In: Froede RC, ed. Handbook of Forensic Pathology. 2nd ed. Chicago, Ill: College of American Pathologists; 2003:175-183.

5. Donoghue ER, Kalelkar MB, Richmond JM, Teas SS. Atypical gunshot wounds of entrance: an empirical study. J Forensic Sci. 1984;29:379-388.

6. Druid H, Ward ME. Incomplete shored exit wounds: a report of three cases. Am J Forensic Med Pathol. 2000;21:220-224.

7. DiMaio VJM. Gunshot Wounds-Practical Aspects of Firearms, Ballistics and Forensic Techniques. 2nd ed. Boca Raton, Fla: CRC Press; 1999:93-94.

8. Spitz WU. Injury by gunfire. In: Spitz WU, ed. Spitz and Fisher's Medicolegal Investigation of Death. 3rd ed. Springfield, Ill: Charles C Thomas; 1993: 311-332.