Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 3-4, Pages: 242-246
https://doi.org/10.2298/SARH1304242Z
Full text ( 1097 KB)
Bullet embolism in a case of homicide: Case report
Živković Vladimir (Medicinski fakultet, Institut za sudsku medicinu, Beograd)
Juković Fehim (Opšta bolnica, Odeljenje za patologiju i sudsku medicinu, Novi Pazar)
Nikolić Slobodan (Medicinski fakultet, Institut za sudsku medicinu, Beograd)
Introduction. Bullet embolism is a special form of embolism, where embolus is
either a bullet or its fragment. Bullet penetrates through the injured part
of the body into circulation and then travels to a distant part of the body,
until it gets blocked in a vessel of the same diameter as the bullet. Case
Outline. We are presenting a case of gunshot injury in a 26yearold male,
found unconscious on the passenger seat, with the gunshot injury of the right
hand and hemithorax, who died two hours after admission to hospital.
Postmortem Xray revealed the presence of a metallic foreign body - a
bullet, in the level of the left femoral neck. The autopsy revealed entrance
and exit gunshot wounds of the upper third of the right upper arm. There was
a second entrance gunshot wound, and the bullet passed through the right
hemithorax and the right lung, and then through the intervertebral disc
between the eighth and ninth thoracic vertebrae, and also making a complete
laceration of the wall of the thoracic aorta, in the right posterior
semicircumference. The slightly deformed bul let, caliber 7.65 mm, was found
embedded in the lumen of the vessel at the bifurcation of the deep femoral
artery from the left femoral artery. Conclusion. Bullet embolism is a rare
complication of gunshot wounds. It should be suspected in any gunshot wound
victim without an exit wound, or the lack of a missile in the bullet pathway,
or if there are premortem signs or symptoms unexpected for the presumed
pathway of the bullet, such as distant ischemia or infection. In these cases,
some of postmortem imaging techniques should be used to save time in
diagnosis, treatment and at autopsy.
Keywords: bullet embolism, gunshot wounds, vital reaction, forensic pathology, autopsy