Incidental occult gunshot wound detected by postmortem computed tomography

Area of Science:

• Forensic pathology
• Radiology
• Medical imaging

Background:

• Routine pre-autopsy imaging is increasingly utilized in forensic investigations.
• Postmortem computed tomography (PMCT) offers non-invasive detailed anatomical visualization.

Observation:

• A 59-year-old female body underwent 256-slice multidetector row CT scan before autopsy.
• A large left tension pneumothorax was identified as a probable cause of death.
• An unsuspected projectile fragment from a prior gunshot injury was detected in the facial region.

Findings:

• PMCT accurately diagnosed the cause of death (tension pneumothorax).
• PMCT revealed a previously unknown old gunshot wound to the face, including projectile fragments.
• Autopsy findings correlated with and confirmed the PMCT discoveries.

Implications:

• Routine PMCT enhances the diagnostic yield of forensic autopsies.
• PMCT can uncover significant incidental findings that might otherwise be missed.
• Integrating advanced imaging improves the comprehensiveness of death investigations.