Sternal Foramen Mimicking Gunshot Injury: A Forensic Case Report

The sternum develops from multiple ossification centers, and their incomplete fusion can lead to congenital anomalies like sternal foramina; although typically asymptomatic, these foramina possess significant clinical and forensic relevance due to their potential mimicry of penetrating traumatic injuries such as gunshot wounds. We present a forensic case involving a highly decomposed body, recovered from a submerged vehicle two years post-incident, which exhibited a distinct sternal defect initially suspected as a gunshot wound based on its location and appearance. However, meticulous skeletal examination revealed features consistent with a congenital sternal foramen, including smooth, well-corticated margins and uniform defect dimensions, which allowed for the exclusion of trauma due to the absence of typical gunshot wound characteristics like bevelling, radiating fractures, and bone fragmentation. This case crucially highlights the importance for forensic pathologists to recognize and accurately differentiate anatomical variants like sternal foramina, thereby preventing misinterpretation of the cause and manner of death and ensuring accurate medico-legal conclusions.