Post mortem computed tomography: useful or unnecessary in gunshot wounds deaths? Two case reports

Abstract

Post-mortem computer tomography (PMCT) is currently an useful procedure that can elucidate patterns of injuries, providing strong medical evidence that is very useful during litigation and at trial. This technique is especially useful in gunshot wounds cases, allowing an easier location and retrieval of the bullet and/or its fragments inside the body. In such cases, the use of 3D rendering can be very useful in order to obtain essential information, such as: accurate depict of the wound track, discerning between entrance and exit wounds, show bone's fracture and its fragments course inside the body. The authors performed analysis on two cases of death by gunshot wounds, and a PMCT before the postmortem examination was made. The obtained CT scans were evaluated using the open-source software OsiriX on a Mac OS X computer, performing 3D rendering of the DICOM images. The crime scene reconstruction was performed using the software Poser Debut® on a Mac OS X computer. In both cases, PMCT showed multiple advantages: objectivity, reproducibility, ease visualization of the wound paths, easy localization of bullet and their fragments, allowing us to clarify the cause of death before the traditional autopsy. PMCT should became a standard in forensic practice as an aid to the tradition postmortem examination to obtain as much information as possible in order to clarify the cause and manner of death.

Keywords: 3D-CT reconstructions; Brenneke; Gunshot injuries; Trauma; Virtopsy.