Anatomy of a Gunshot: Complementary Findings From Post-mortem Computed Tomography and Autopsy in a Fatal Thoracic Firearm Injury

Forensic interpretation of firearm injuries requires careful separation of observed pathology from inferences about firing distance, projectile behaviour, and the circumstances of discharge.We describe the investigation of a fatal penetrating thoracic firearm injury in a 27-year-old woman examined using postmortem computed tomography (PMCT) and conventional medicolegal autopsy.A single oval entry wound, measuring 1.6 × 1.0 cm, was present over the right parasternal region at the level of the third costal cartilage, with an eccentric abrasion collar.Multiple punctate skin lesions described as powder tattooing were distributed over exposed areas, particularly the dorsum of the right hand and distal forearm, and over the anterior neck and lower face; relative sparing was noted beneath the upper garment.Autopsy documented a broadly posterior, inferior, and leftward wound pathway involving the right lung, pericardium, major thoracic vessels, right main bronchus, and thoracic vertebrae.A deformed jacketed projectile was recovered from the left posterior thoracic wall.PMCT localised the retained projectile and demonstrated thoracic vertebral injury before dissection.Fatal haemorrhage from major intrathoracic injuries was the principal pathological finding.The pattern of skin lesions is compatible with exposure to discharge-associated particulate material, but a precise muzzle-to-target distance, firearm classification, and body position cannot be determined from the reported data.This case illustrates the complementary roles of imaging and autopsy and the need to express reconstructive conclusions according to the strength and limitations of the actual observations.