Popliteal artery bullet embolism in a case of homicide: a case report and review of the tangible literature

Abstract

Bullet embolism is a well known but a relatively rare phenomenon in common medicolegal autopsy practice. We present a homicide case of a bullet embolism to the left popliteal artery with interesting trajectory of projectile through the chest wall and right heart ventricle into the aortic lumen. Since in our presented case obvious homicidal manner of death was in question, discovery of bullet was an obligatory part of investigation in order to positively identify the responsible firearm. Detection of the missile transported through the circulation requires very thorough autopsy examination, especially if X-ray equipment is not available. As in all other cases in which initial bullet trajectory is changed in the body, the very important part of the medicolegal autopsy in cases accompanied with missile embolism, is to determine direction of the first part of the bullet’s trajectory, because this indicates the position of the axis of the weapon barrel in the moment of firing (if there was no external ricochet), taking into consideration the posture of the victim and the location of the shooting person in the same moment. A review of the tangible literature is given.