{"id":1945,"date":"2024-10-12T18:23:13","date_gmt":"2024-10-12T22:23:13","guid":{"rendered":"https:\/\/wordpress.forensicpath.us\/?p=1945"},"modified":"2024-10-12T18:23:13","modified_gmt":"2024-10-12T22:23:13","slug":"pathology-cases-when-beveling-can-be-misleading-in-gunshot-wounds","status":"publish","type":"post","link":"https:\/\/wordpress.forensicpath.us\/index.php\/2024\/10\/12\/pathology-cases-when-beveling-can-be-misleading-in-gunshot-wounds\/","title":{"rendered":"Pathology cases — when beveling can be misleading in gunshot wounds"},"content":{"rendered":"

Here’s an interesting case, I think, of determining entrance and exit.\u00a0 \u00a0In fact, it’s pretty trivial because of soot deposition, but the other morphological features are a little iffy.<\/p>\n

So, consider the basic rules for entrance v exit, a problem we come across every day.\u00a0 The rules of thumb are:<\/p>\n

    \n
  1. Entrances tend to be smaller and round, while exits are either slit-like or big and stellate, depending on velocity and range.<\/li>\n
  2. When going through bone, particularly flat bone, you get beveling of the inner or outer table with the big end pointing in the direction of flight<\/li>\n
  3. \u00a0There will be soot, powder, or searing on the edge or in the wound at the entrance for a close\/contact wound or stippling for an intermediate range wound.<\/li>\n<\/ol>\n

    Of course, there are exceptions all over the place.\u00a0 You can get stellate entrance wounds over the skull with close range\/contact injuries all the time, because of gas hitting the bone.\u00a0 If there’s a lot of hair or a hat or something, you may not get much soot at the edge of the wound, and it may not be obvious in the wound path.\u00a0 Personally, I place a lot of faith in beveling when it comes to gunshot wounds of the skull.\u00a0 it almost never takes me down the wrong path.<\/p>\n

    But here’s the exception to the rule. Here are two wounds.\u00a0 One in the right temple and one in the occiput:<\/p>\n

     <\/p>\n

    \"\"<\/a> \"\"<\/a><\/p>\n

    Now, ignoring the soot in the shot in the temple, the entrance and exit look fairly similar.\u00a0 The close-ups demonstrate the soot well in the entrance:<\/p>\n

     <\/p>\n

    \"\"<\/a><\/p>\n

    \"\"<\/a><\/p>\n

     <\/p>\n

    But here’s the kicker.\u00a0 Here’s the entrance wound in the lateral wall of the middle fossa on the right.\u00a0 Again, the soot is a lifesaver, but you’ll notice there isn’t much beveling:<\/p>\n

    \"\"<\/a> \"\"<\/a><\/p>\n

    But, if you look at the exit, it *seems* there is beveling going the wrong way.\u00a0 Closer inspection shows that the “beveling” is really soft tissue outside of the skull.\u00a0 But even so, the fracture pattern gives a little hint of beveling going the wrong way…<\/p>\n

    \"\"<\/a> \"\"<\/a><\/p>\n

    Not a major diagnostic dilemma, but I think it shows you can’t be dogmatic about any individual indicator.\u00a0 Even soot isn’t the end all and be all.\u00a0 We all know about “pseudosoot.”\u00a0 And if you don’t, look it up…<\/p>\n

    As always free for use with or without attribution, though attribution is appreciated.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Here’s an interesting case, I think, of determining entrance and exit.\u00a0 \u00a0In fact, it’s pretty trivial because of soot deposition,…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[108,109],"tags":[59,118,28,130],"class_list":["post-1945","post","type-post","status-publish","format-standard","hentry","category-gross-pathology","category-pathology-cases","tag-autopsy","tag-gunshot-wound","tag-pathology","tag-skull"],"_links":{"self":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1945","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/comments?post=1945"}],"version-history":[{"count":1,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1945\/revisions"}],"predecessor-version":[{"id":1955,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1945\/revisions\/1955"}],"wp:attachment":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/media?parent=1945"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/categories?post=1945"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/tags?post=1945"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}