The study of gunshot wounds in surgical pathology

Both the laboratory and the pathologist are frequently involved in medicolegal cases. A relatively infrequent though important example is the case involving study of gunshot wounds in surgical pathology. Procedures for the proper gross and microscopic examination of gunshot wound specimens have been documented in the literature, and are briefly reviewed. A protocol for documenting the chain of custody for physical evidence recovered in these cases must be strictly observed in each department of surgical pathology. A large hospital's surgical pathology files contained 70 gunshot wound cases for 1969-1978. Review employing Adelson's reference work revealed correct microscopic findings and diagnosis in 90% of specimens, the 11 errors all failures to recognize gunpowder residue in tissues. There were nine specimens of physical evidence. Two errors were made in the gross examination of these specimens, and despite a chain-of-custody protocol pathologists failed to adequately document 44% of them. The surgical pathologist has available ample resources for studying gunshot wound specimens. Using them he can correctly interpret most cases, at the same time fulfilling his medicolegal obligations.