title: An unusual case of multiple-gunshot suicide of an alcohol-intoxicated cancer sufferer with prolonged physical activity.
abstract: Multishot firearm suicides are relatively rare and suggest the possibility of homicide. Physical activity following gunshots to the head, the neck, and the thorax does occur, and immediate incapacitation does not occur in every fatal gunshot wound that penetrates the head or perforates the heart. Cancer patients appear to be at increased suicide risk, but alcohol intoxication is less common in such cases. We present-to the best of our knowledge for the first time-a case of a 54-year old, male, liver cancer sufferer, who under the influence of alcohol, discharged his revolver three times, suffered, among other wounds, a heart-perforating wound, and died after c. 1.5 h, being able to talk until just before he died. Our case underlines the importance of keeping an open critical mind when dealing with multiple-gunshot fatalities, especially when posttraumatic physical activity might be crucial in differentiating homicide from suicide.
authors: Department of Pathology, Karolinska University Hospital and Karolinska Institute, Huddinge, Stockholm, Sweden.
authors: Andreas
authors: A
authors: Marnerides
authors: Eleni
authors: E
authors: Zagelidou
authors: Roumbini
authors: R
authors: Leontari
mesh_terms: D000435:Alcoholic Intoxication; D002305:Cardiac Tamponade / Q000209:etiology / Q000473:pathology; D049429:Forensic Pathology; D020197:Head Injuries, Penetrating / Q000209:etiology / Q000473:pathology; D006335:Heart Injuries / Q000209:etiology / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000523:psychology*; D055370:Lung Injury / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000293:injuries / Q000473:pathology; D035422:Pleural Cavity / Q000293:injuries / Q000473:pathology; D013405:Suicide; D013997:Time Factors; D014948:Wounds, Gunshot / Q000473:pathology*
keywords: alcohol intoxication; cancer; forensic pathology; forensic science; multiple-gunshot suicide; physical activity