title: Forensic issues in suicidal single gunshot injuries to the chest: an autopsy study.
abstract: This study presents a case series of suicides carried out by self-inflicted gunshot wounds to the chest-a relatively uncommon means of suicide. The retrospective autopsy study performed included all cases of single suicidal gunshot injuries to the chest during a 20-year period and which were committed by the use of a handgun. The sample included 67 deceased persons that were an average of 44.4 ± 19.1 years old (range, 12-89 years; 58 men and 9 women). The most common region of the entrance wound was the left side of the chest (54/67), followed by the sternum (10/67), and the right side of the chest (3/67). For 9 subjects, the range of fire could not be determined, as well as whether the shot went through their clothing. In the remaining 58 subjects, only contact or near-contact wounds were found. Of the 58, only 3 subjects had their clothing removed between the chest wall and the muzzle. Three directions of the internal bullet paths were those most frequently found: downward right-to-left (27/67), downward left-to-right (20/67), and downward parallel (10/67) (χ = 101.045, P = 0.000). Also, most bullet paths were directed downward (57/67, χ = 32.970, P = 0.000). The most frequently injured organ was the heart (47/67), and the immediate causes of death were exsanguination (49/67), heart disruption (14/67), and tamponade (4/67).
authors.affiliation: Institute of Forensic Medicine, University of Belgrade - School of Medicine, Belgrade, Serbia.
authors.forename: Veljko
authors.initials: V
authors.lastname: Strajina
authors.forename: Vladimir
authors.initials: V
authors.lastname: Živković
authors.forename: Slobodan
authors.initials: S
authors.lastname: Nikolić
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002305:Cardiac Tamponade / Q000473:pathology; D002492:Central Nervous System Depressants / Q000097:blood; D002648:Child; D000431:Ethanol / Q000097:blood; D058734:Exsanguination; D005260:Female; D005389:Firearms / Q000706:statistics & numerical data; D044709:Forensic Ballistics; D049429:Forensic Pathology; D006335:Heart Injuries / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D013405:Suicide; D013898:Thoracic Injuries / Q000473:pathology*; D014948:Wounds, Gunshot / Q000473:pathology*; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol