Table 1:
A Comparison of Scenarios Which Can Cause Confusion Regarding the Number of Entrances and Exits and Projectiles Visualized on Initial Imaging at Autopsy
| Situations Which Suggest That a Bullet/Projectile is Unaccounted for During Initial Exam and Imaging | Situations Which Suggest That There are Too Many Bullets/Projectiles (or Too Many Exit Wounds) During Initial Exam and Imaging |
|---|---|
| Misinterpretation of entrance/exit wound(s) | Misinterpretation of entrance/exit wound(s) |
| Overlooking/missing a hidden or subtle exit wound | Overlooking/missing a hidden or subtle entrance wound |
| Graze wound misidentified as an entrance wound | Graze wound misidentified as an exit wound |
| Shored exit wound (14–15) | Partial or incomplete exit wound |
| The presence of a defect which mimics a gun shot wound entrance (16–17) | The presence of a defect which mimics a gun shot wound exit (16–17) |
| Misalignment of radiograph such that area with bullet/projectile is missed | Misinterpreting an object on radiograph as a bullet/projectile |
| Bullet embolus (18-22) | Tandem bullet |
| Overlooking a bullet/projectile on radiograph due to decreased subject contrast and summation artifact (23) | Separation/fragmentation of bullet/projectile after entering body (30) |
| Prior surgical removal (or other movement) of bullet/projectile (+/- relying on antemortem radiographs) (24) | Multiple bullets/projectiles within a single cartridge (33,34) |
| Injury produced by blank cartridge (25-27) | Retained bullet (17) |
| Multiple bullets/projectiles exiting the same exit defect (28) | Multiple bullets/projectiles (from separate shots) entering the same entrance defect (31–32) |
| Bullet/projectile ricochet with subsequent exit via the entrance wound (29) | Misinterpreting an incomplete shored exit wound as a “complete” shored exit wound (15) |