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Atlas of Postmortem Angiography pp 453–490Cite as

Gunshot Trauma

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Abstract

Injuries inflicted by gunshot trauma result from different kinds of firearms and similar devices. Ballistic trauma can produce damage to tissues that is quite similar to that inflicted by other types of instruments involved in mechanical trauma, but because of the transfer of a large amount of energy, firearm injuries can be extremely destructive. Additionally, some specific questions relate to the investigation of gunshot injury cases. The following features are important for forensic reconstruction of the event: locating and distinguishing the entrance and exit wounds, the range of fire, the bullet course through the body (trajectory), and remaining projectiles or their fragments as well as information about the kind of missile. In recent years, postmortem computed tomography (PMCT) has been gradually replacing x-ray examination for this purpose in forensic death investigations. This technology offers special opportunities for investigating gunshot trauma cases, especially through the simple detection of foreign bodies such as projectiles, a high sensitivity for detecting bone lesions, and the possibility of multiplanar reconstructions that allow visualization of trajectories and generation of three-dimensional (3D) images. To perform diagnosis concerning lesions of the vascular system, soft tissue, and parenchymatous organs, the sensitivity of PMCT can be greatly increased by postmortem angiography (PMCTA). Because firearm lesions can appear at multiple sites of the body and rarely concern only one organ, whole-body angiography methods are the tools of choice for investigating these lesions and their consequences. This chapter explains the possibilities offered by the technique of multiphase PMCT angiography (MPMCTA), which is regularly applied in cases of firearm injuries in our centers.

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Acknowledgements

The authors’ PMCTA research was approved by appropriate University Bioethics Committee (KBET/225/B/2012).

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Authors and Affiliations

  1. Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Grzegórzecka 16, 31–531, Kraków, Poland

    Krzysztof Jerzy Woźniak MD, PhD & Artur Moskała MD

  2. University Center of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland

    Silke Grabherr MD, PhD

Authors
  1. Krzysztof Jerzy Woźniak MD, PhD
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  2. Artur Moskała MD
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  3. Silke Grabherr MD, PhD
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Correspondence to Krzysztof Jerzy Woźniak MD, PhD .

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Editors and Affiliations

  1. University Center of Legal Medicine, Lausanne, Switzerland

    Silke Grabherr

  2. University Center of Legal Medicine, University Hospital Center Vaudois, Lausanne, Switzerland

    Jochen M. Grimm

  3. Institute of Legal Medicine, University Medical Center Hamburg-Eppend, Hamburg, Germany

    Axel Heinemann

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Woźniak, K.J., Moskała, A., Grabherr, S. (2016). Gunshot Trauma. In: Grabherr, S., Grimm, J., Heinemann, A. (eds) Atlas of Postmortem Angiography. Springer, Cham. https://doi.org/10.1007/978-3-319-28537-5_28

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