			Home About us Contact

Gunshot Wounds (gunshot + wound)

Distribution by Scientific Domains

Medical Sciences	53%

Selected Abstracts

Analysis of 153 gunshot wounds of the liver

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2000
J. D. F. Marr
Background Gunshot wounds of the liver may result in substantial morbidity and death, and optimal management of complex injuries is controversial. Methods One hundred and fifty-three patients with civilian gunshot liver injuries were treated during the 10-year period 1986,1995. Demographic, clinical and operative data were recorded. Factors influencing postoperative complications and death were analysed. Results One hundred and forty-two patients (93 per cent) had single missile injuries and 11 (7 per cent) had shotgun injuries. Three patients were treated non-operatively and 150 patients underwent operation. In 105 patients (70 per cent) the injuries to the liver were minor and required either no treatment (93) or simple suture of bleeding vessels (12). Forty-five patients (30 per cent) had major injuries which were either packed only (26) or required more complex surgical intervention (19). This included resectional debridement (ten), major venous repair (eight) and hepatotomy (one); eight of these patients required packing combined with the procedure. Associated intra-abdominal injuries occurred in 115 patients (77 per cent). The overall mortality rate was 17 per cent (26 patients). Death was directly attributable to the liver injury in 13 patients (8 per cent), 12 of whom died from uncontrolled bleeding. Complications occurred in 63 (51 per cent) of 124 survivors, and correlated with the type and severity of the liver injury and the number of associated injuries. Conclusion Most gunshot liver injuries can be managed by simple surgical techniques. In complex injuries control of major haemorrhage is vital and perihepatic packing may be life saving before undertaking definitive repair of the injury under controlled conditions. © 2000 British Journal of Surgery Society Ltd [source]

An Unusual Zip Gun Suicide,Medicolegal and Ballistic Examination

JOURNAL OF FORENSIC SCIENCES, Issue 1 2010
Petr Hejna M.D., Ph.D.
Abstract:, Home-made guns are imitations of typical firearms and usually have handgun characteristics. This article presents an unusual case of a suicide carried out by means of a fatal gunshot wound to the head using a home-made zip gun. A 49-year-old male, with a history of paranoid psychosis was found dead in the dwelling place of a family house. The investigation at the crime scene did not lead to suspicion of a gunshot wound because of the unusual nature of the firearm used. A medical examiner diagnosed an opened head injury as the primary cause of the victim's death. The autopsy findings provided immediate grounds for further inspection of the crime scene. Subsequently, a simple zip gun, which had been overlooked during the scene investigation, was discovered. An undeformed projectile recovered from the victim's head was consistent with the use of the home-made firearm. Following the completion of the investigations and autopsy, the death was classified as a suicide. [source]

Cerebral gunshot wounds: a score based on three clinical parameters to predict the risk of early mortality

ANZ JOURNAL OF SURGERY, Issue 11 2009
Michael Stoffel
Abstract Background:, To provide a score to predict the risk of early mortality after single craniocerebral gunshot wound (GSW) based on three clinical parameters. Methods:, All patients admitted to Baragwanath Hospital, Johannesburg, South Africa, between October 2000 and May 2005 for an isolated single craniocerebral GSW were retrospectively evaluated for the documentation of (i) blood pressure (BP) on admission; (ii) inspection of the bullet entry and exit site; and (iii) initial consciousness (n= 214). Results:, Conscious GSW victims had an early mortality risk of 8.3%, unconscious patients a more than fourfold higher risk (39.2%). Patients with a systolic BP between 100 and 199 mm Hg had an 18.2% risk of mortality. Hypotension (<100 mm Hg) doubled this risk (37.7%) and severe hypertension (,200 mm Hg) was associated with an even higher mortality rate of 57.1%. Patients without brain spilling out of the wound (,non-oozer') exhibited a mortality of 19.7%, whereas it was twice as high (43.3%) in patients with brain spill (,oozer'). By logistic regression, a prognostic index for each variant of the evaluated parameters could be established: non-oozer:0, oozer:1, conscious:0, unconscious:2, 100 ,RRsys < 200 mm Hg:0, RRsys < 100 mm Hg:1, RRsys, 200 mm Hg:2. This resulted in a score (0,5) by which the individual risk of early mortality after GSW can be anticipated. Conclusions:, Three immediately obtainable clinical parameters were evaluated and a score for predicting the risk of early mortality after a single craniocerebral GSW was established. [source]

Shooting Through Clothing in Firearm Suicides

JOURNAL OF FORENSIC SCIENCES, Issue 3 2010
Petr Hejna M.D., Ph.D.
Abstract:, There is a longstanding empirical rule that people who commit suicide rarely shoot through their clothing, but rather put it aside to expose the nude skin. Signs of shots through clothing have always been considered suspicious, raising presumptions of the presence of an abettor. Our report, based on a retrospective study of fatal suicidal firearm injuries from the years 1980 to 2007, points out that suicide victims only rarely remove clothing from the site of the future entry wound. The report covered 43 cases with fatal gunshot wounds in the area of the thorax, with only four persons (9%) removing the clothing present in the area of the subsequent self-inflicted wound. Defects present on the clothing of a victim cannot, therefore, be understood as an absolute criterion for disproving the possibility of suicide, and nor do they necessarily indicate an unfortunate accident or homicide. If, however, the suicide victim removes the clothing from the area of the future wound, then this is almost always an indication of suicide. [source]

Effects of Decomposition on Gunshot Wound Characteristics: Under Moderate Temperatures with Insect Activity

JOURNAL OF FORENSIC SCIENCES, Issue 2 2009
Lauren E. MacAulay B.Sc. (Hons)
Abstract:, Previous studies document characteristics of gunshot wounds shortly after they were inflicted. This study was conducted to determine if the early stages of decomposition obscure or alter the physical surface characteristics of gunshot wounds, thereby affecting the quantity and quality of information retrievable from such evidence. The study was conducted in August and September, 2005 in Nova Scotia, Canada in forested and exposed environments. Recently killed pigs were used as research models and were shot six times each at three different ranges (contact, 2.5 cm, and 1.5 m). Under these test conditions, the gunshot wounds maintained the characteristics unique to each gunshot range and changes that occurred during decomposition were not critical to the interpretation of the evidence. It was concluded that changes due to decomposition under the conditions tested would not affect the collection and interpretation of gunshot wound evidence until the skin was degraded in the late active or advanced decay stage of decomposition. [source]

Effects of Decomposition on Gunshot Wound Characteristics: Under Cold Temperatures with No Insect Activity

JOURNAL OF FORENSIC SCIENCES, Issue 2 2009
Lauren E. MacAulay B.Sc. (Hons)
Abstract:, Information on gunshot wound characteristics has been well documented; however, there is little documented information on the effects of decomposition or environmental conditions on gunshot wound characteristics. This study was conducted in order to determine if decomposition would obscure or alter the physical surface characteristics of gunshot wounds when exposed to a low temperature environment. The study was conducted from November 2005 to January 2006 in Nova Scotia, Canada in forested and exposed environments, with air temperatures between ,10°C and +10°C. Pigs were used as human models and were shot six times each at three different ranges (contact, 2.5 cm, and 1.5 m). Gunshot wound characteristics persisted until the wounds were covered with ice and snow, after which changes were observed. The changes were recognized as being unique to the different ranges of gunshots and it was concluded that changes due to decomposition under the conditions tested would not affect the collection and interpretation of gunshot wound evidence. [source]

Healing Following Cranial Trauma,

JOURNAL OF FORENSIC SCIENCES, Issue 2 2008
Lenore T. Barbian Ph.D.
Abstract:, This paper reports on the gross appearance of the initial osseous response following cranial gunshot wounds. A total of 127 adult crania and cranial sections were analyzed for four types of bone response: osteoblastic, osteoclastic, line of demarcation, and sequestration. In general, no osteoblastic or osteoclastic response was noted during the first week. This response was followed by an increasing prevalence of expression after this time. By the sixth week postfracture both osteoclastic and osteoblastic activity was scored for 100% of the sample. Further, our observations suggest that the line of demarcation may establish the boundary between the living bone and bone not surviving the fracture. Sequestration appears to be a long-term event and was scored as present well past the eighth week of healing. The osseous expression of infection following fracture was also considered. [source]

Cerebral gunshot wounds: a score based on three clinical parameters to predict the risk of early mortality

HP38P MANAGEMENT OF TRAUMATIC PANCREATIC INJURY

ANZ JOURNAL OF SURGERY, Issue 2007
A. M. Warwick
Background Trauma to the pancreas is a challenging area both in initial diagnosis and longer-term management. The retroperitoneal location makes clinical diagnosis of injury difficult and delayed diagnosis has morbid complications. Methods A review of patients with a diagnosis of traumatic pancreatic injury was performed, over a period of five years, from 2002 to 2006. We assessed the type of injury that occurred in the pancreas after both blunt and penetrating trauma; the diagnosis and timing of pancreatic injury; the need for operative/radiological intervention; and the complications of these injuries. Specifically patients with complex injuries were evaluated and these cases were critically reviewed. Results We identified 45 of cases of pancreatic trauma, aged 16,85, with a mean ISS of 27.8. Minor injury to the pancreas was found in 29 patients, and 16 patients had severe trauma to the pancreas, either major laceration or transection. Four particularly complex cases were identified, two of which required a Whipple's procedure following gunshot wounds involving the pancreatic head. Two patients with abdominal crush injuries required multiple interventions. Conclusions Patients with pancreatic trauma often have other significant injuries and one should have a high degree of suspicion of pancreatic injury in multiply injured patients. Penetrating injury to the pancreas can result in catastrophic injury requiring radical surgery. Blunt injury should be assessed by magnetic resonance cholangio-pancreatography or at laparotomy. The management of pancreatic trauma is complex and these patients should be managed in a tertiary hospital with involvement by both specialised pancreatic and trauma surgeons. [source]

World War I: the genesis of craniomaxillofacial surgery?

ANZ JOURNAL OF SURGERY, Issue 1-2 2004
Donald A. Simpson
Herbert Moran enlisted in the Royal Army Medical Corps early in World War I. His autobiography captures the impact of contemporary experience of wartime gunshot wounds, seen in vast numbers and with little understanding of the requirements of wartime surgery. Wounds of the face and brain were numerous, especially in trench fighting. In France, Germany, Britain and elsewhere, surgeons and dentists collaborated to repair mutilated faces and special centres were set up to facilitate this. The innovative New Zealand surgeon Harold Gillies developed his famous reconstructive techniques in the Queen's Hospital at Sidcup, with the help of dental surgeons, anaesthetists and medical artists. The treatment of brain wounds was controversial. Many surgeons, especially on the German side, advocated minimal primary operative surgery and delayed closure. Others advocated early exploration and immediate closure; among the first to do so was the Austro-Hungarian otologist Robert Bárány. In 1918, the pioneer American neurosurgeon Harvey Cushing published well-documented proof of the desirability of definitive operative management done as soon as possible. Few World War I surgeons developed their knowledge of plastic surgery, neurosurgery and oral surgery in post-war practice. An exception was Henry Newland, who went on to pioneer the development of these specialties in Australasia. After World War II, the French plastic surgeon Paul Tessier created the multidisciplinary subspecialty of craniomaxillofacial surgery, with the help of his neurosurgical colleague Gérard Guiot, and applied this approach to the correction of facial deformities. It has become evident that the new subspecialty requires appropriate training programs. [source]

Management of gunshot wounds at a Sydney teaching hospital

ANZ JOURNAL OF SURGERY, Issue 1 2001
Michael Sugrue
No abstract is available for this article. [source]