Case ReportsPostmortem Computed Tomography and Magnetic Resonance Imaging of an Abdominal Gunshot WoundGascho, Dominic RT∗; Bolliger, Stephan A. MD∗; Thali, Michael J. MD∗; Tappero, Carlo MD∗,†Author Information From the ∗Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich †Department of Radiology, Hôpital Fribourgeois, Fribourg, Switzerland. Manuscript received November 25, 2019; accepted February 28, 2020. The authors report no conflict of interest. Reprints: Dominic Gascho, Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich Winterthurerstrasse 190/52, CH-8057 Zurich, Switzerland. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: June 2020 - Volume 41 - Issue 2 - p 119-123 doi: 10.1097/PAF.0000000000000547 Buy Metrics Abstract The use of postmortem computed tomography (CT) has been described in many articles concerning gunshot injuries. Postmortem magnetic resonance imaging (MRI) for better assessment of soft tissue injuries has also been mentioned in the literature, albeit much less often. The use of postmortem MRI for abdominal gunshot wounds has not been previously presented in the literature. The present case report describes the findings of an abdominal gunshot wound detected by postmortem CT and MRI, followed by an autopsy. The main imaging findings on CT were a hyperdense ring at the entrance wound, which indicated the muzzle imprint mark, a hyperdense region beneath the skin, which was suggestive of combustion residue, gas cavities surrounding the bullet path, which might be related to the temporary cavity, and a fracture of the 13th rib on the left. Magnetic resonance imaging provided a clear depiction of defects in the muscle tissue and peritoneal fat, as well as an injury to the left kidney and a large volume of blood in the abdominal cavity. Computed tomography combined with MRI provided a descriptive presentation of the intracorporeal trajectory noninvasively. Autopsy confirmed the radiologic findings but additionally revealed further relevant findings, which were not detected radiologically, such as a duodenal perforation. Autopsy also detected subendocardial hemorrhages and shock kidney, which were consistent with severe blood loss. The imaging findings and their interpretations are discussed in this case report, as well as the role of CT and MRI in the assessment of abdominal gunshot wounds compared with autopsy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.