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Types of injuries

Gunshot wounds

Author: Lindsey Harle, M.D. (see Reviewers page)
Revised: 26 March 2012, last major update March 2012
Copyright: (c) 2012, PathologyOutlines.com, Inc.


● Entry wounds are categorized based on range

Contact: muzzle is pressed against the skin when fired
● In areas of “loose” skin (abdomen, chest): circular wound with blackened, seared skin margins
● On head, where the scalp is tightly covering the skull, entry wounds can have several different appearances:
     ● Round wound with blackened, seared skin margins
     ● Stellate shaped wound, due to tearing of skin from expanding gas dissecting between the scalp and skull
     ● Round wound with muzzle imprint, also due to gas expanding under the skin causing it to press back against the gun

Near contact: muzzle of the gun is held a short distance from the skin (< 1 cm from skin with handguns)
● Appears as circular wound with blackened and seared edges that are wider than seen with contact wounds

Intermediate: defined by the presence of stippling (“powder tattooing”) on the skin surrounding the entry wound
● Stippling is due to unburned powder grains exiting from the gun causing pinpoint abrasions on the skin; these are not burns
● Actual distance from skin varies according to the gun; generally from a few centimeters up to several feet

Distant: any distance beyond that which produces stippling
● Appear as round wounds with sharp margins and an abrasion ring on the surrounding skin

Centerfire rifle wounds:
● In contact wounds of the head with centerfire rifles, there is massive tissue destruction of the skin, skull, and brain
● Full metal jacketed bullets produce less tissue damage and tend to travel through the body undeformed
● Semi-jacketed ammunition creates the classic “lead snowstorm” appearance on x-ray due to peeling back of the jacket as it travels through the body, releasing numerous small lead fragments

Shotgun wounds:
● Shotgun bullets contain numerous pellets
● At contact range up to a few feet, the entrance wound is a single round defect
● At a range of 3-4 feet, the pellets begin to spread out before reaching the body, producing one large entry wound surrounded by scalloping or several smaller defects due to penetration by individual pellets
● As the range increases, the central defect becomes smaller and the number of surrounding pellet holes increases

Exit wounds:
● Usually more irregular in shape than entry wounds
● Do not show soot deposition, muzzle imprint, stippling, or blackening of the skin edges
● A shored exit wound is one in which the skin is in contact with another object when the bullet exits; this causes an irregular area of abrasion on the skin, which can be confused with the abrasion ring of an entrance wound

Gunshot wounds in bone:
● In flat bones (i.e. skull), entrance wounds are round with sharp margins and show internal beveling: the inner table of the skull is more eroded than the outer table, producing a “cone” shape in the direction of the bullet path
● Fragments of bone travel in the direction of the bullet path through the cranial vault
● Exit wounds may be more irregular and show external beveling (outer table of the skull is more eroded than the inner table, producing a cone shape facing outward)
● In the skull, gunshot wounds often produce numerous fractures due to rapidly increasing pressure as the bullet travels through the skull

End of Forensics > Gunshot wounds

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