Abstract
BackgroundFirearm injuries are a common cause of death in cases typically investigated by medical examiners. Postmortem multislice computed tomography (PMCT) provides valuable information that enhances the autopsy examination. This study was conducted to compare PMCT and autopsy for the detection of injuries and causes of death in cases of fatal firearm injuries. Thirty cadavers were scanned with PMCT and then underwent autopsy. The results of the two techniques were compared regarding entry wounds, wound channels, detection of foreign bodies, organ and skeletal injuries, and causes of death to determine the concordance or discordance between the two techniques.ResultsThe results revealed excellent agreement between PMCT and autopsy for the detection of injuries and causes of death in cases of gunshot injury. Furthermore, PMCT revealed injuries such as pneumothorax and surgical emphysema that were found to be undetermined by autopsies where the special dissection technique was not part of our routine procedures.ConclusionPMCT could be a valuable complementary tool for autopsies to determine and localize injuries and causes of death in cases of gunshot injury.
Highlights
Firearm injuries are a common cause of death in cases typically investigated by medical examiners
Postmortem multislice computed tomography (PMCT) detected comminuted fractures in the vault of the skull and facial bone fracture in 8 of 12 cases, while autopsy detected these in 6 cases (K (0.67), P < 0.01; Figs. 1 and 3; Table 1)
Pneumocephalus was detected by PMCT in 8 of 12 cases but was not detected by autopsy in any case (K (0), P = 1)
Summary
Firearm injuries are a common cause of death in cases typically investigated by medical examiners. This study was conducted to compare PMCT and autopsy for the detection of injuries and causes of death in cases of fatal firearm injuries. Autopsy is the traditional means of postmortem investigation in humans It is very important for determining the cause and manner of death (DiMaio 2002; Madea and Argo 2014). Previous studies of postmortem investigations of both natural and unnatural death have shown that the diagnostic yield increases, for the detection of fractures, hemorrhage, Elkhateeb et al Egyptian Journal of Forensic Sciences (2018) 8:50 and gas collections, such as pneumothorax, when PMCT is performed with an autopsy (Westphal et al 2012; Wichmann et al 2012 Leth et al 2013; Rutty et al 2013; Lo Re et al 2015)
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