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The Atypical Entrance Wound: Differential Diagnosis and Discussion of an Unusual Cause

Molina, D. Kimberley MD*; Rulon, Jennifer J. MD*; Wallace, Edward I. MSc, BSc (Hons)

The American Journal of Forensic Medicine and Pathology: September 2012 - Volume 33 - Issue 3 - p 250–252
doi: 10.1097/PAF.0b013e3181e5e0f8
Case Reports

The appearance of gunshot entrance wounds on the body depends upon many factors including, the type of firearm, the type of ammunition, the location of the wound on the body, and the circumstances of how a wound was sustained. Atypical gunshot entrance wounds are usually created when the bullet is destabilized prior to entering the body and consequently does not enter the body nose first but sideways or at an angle. The most common causes of an atypical entrance wound are bullet ricochet and interaction with an intermediate target. A case is presented in which the decedent sustained a gunshot wound with an atypical entrance. The cause of the atypical nature of the wound was determined to be increased yaw due to bullet instability caused by the condition of the firearm used, not a ricochet or intermediate target. The case emphasizes the importance of collaborative investigation between the different forensic agencies in gunshot cases.

From the *Bexar County Medical Examiner’s Office; and †Bexar County Criminal Investigations Laboratory, San Antonio, TX.

Manuscript received January 29, 2010; accepted March 27, 2010.

The authors report no conflicts of interest.

Reprints: D. Kimberley Molina, MD, BCMEO, 7337 Louis Pasteur Dr, San Antonio, TX 78229. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.