Unusual bullet embolism in the brachial artery: Case report and literature review |
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| Affiliation: | 1. CHU Nancy, Pole URM, Department of Legal Medicine, Nancy F-54000, France;2. Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia;3. Guilloz Imaging Department, Hôpital Central, CHU Nancy, 5400 Nancy, France;4. Aix Marseille University, CNRS, EFS, ADES, Marseille France;5. Department of Forensic Medicine, Montpellier University Hospital, Montpellier, France;1. Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute – Università degli Studi di Milano, Via Luigi Mangiagalli, 37 – 20133 Milano, Italy;2. Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico di Milano, Anatomopatologo dirigente medico UOC Anatimia Patologica, Milano Italy;1. Forensic Science Laboratory, Tokyo Metropolitan Police Department, 2-1-1, Kasumigaseki, Chiyoda-Ku, Tokyo 100-8929, Japan;2. Department of Forensic Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan;1. West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China;2. Criminal Investigation Department of Sichuan Provincial Public Security Bureau, Chengdu, Sichuan 610015, PR China;3. Department of Stomatology, People''s Hospital of Tibet Autonomous Region, Tibet Autonomous Region, Lhasa 540000, PR China;4. Shanghai Key Laboratory of Forensic Medicine, Academy of Forensic Science, Ministry of Justice, 1347# West Guangfu Road, Shanghai 200063, PR China;1. Department of Legal Medicine, Hyogo College of Medicine, Hyogo, Japan;2. Division of Legal Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan;3. Center of Cause of Death Investigation, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan;4. Center for Genomic Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan;1. Division of Legal Medicine, Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, Kobe, Japan;2. Forensic Science Laboratory, Hyogo Prefectural Police Headquarters, Kobe, Japan;3. Department of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan |
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| Abstract: | Chest cardio-vascular trauma by a gunshot bullet is less common than head trauma in forensic medicine practice, but still an extremely mortal injury. In front of no exit wound, ballistic trajectory could appear unexplained. We present the case of a 43-year-old man who sustained a gunshot wound in his chest. The entrance was facing the sternum and there was no exit wound. An autopsy completed by forensic radiology (CT-scan of the whole body) showed a wound of anterior pericardial, massive bleeding of pericardia, a wound of the anterior ascending thoracic aorta, and then the bullet embolism to the left brachial artery. Without forensic imaging, the bullet was difficult to find. Bullet embolization should be suspected when there is a gunshot injury to the chest without an exit injury and with no projectile in the area, particularly if the projectile is small. Forensic radiology can help to find bullet projectile: by using whole-body radiography or computed tomography. |
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| Keywords: | Bullet embolus Postmortem Computed Tomography Projectile Ballistics Embolization Radiology |
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