Post-mortem CT scan reveals sequential self-inflicted gunshot wounds to the head: Initial non-lethal followed by fatal injury.

INTRODUCTION

Post-mortem imaging plays a crucial role in forensic investigations. While self-inflicted gunshot wounds to the head are common, cases involving multiple shots, especially with a clear sequential pattern, are extremely rare.

CASE PRESENTATION: We report the case of an 82-year-old man found deceased by his wife, seated in a chair with a 9mm firearm on his lap. Two ejected shell casings were found nearby. No signs of struggle or forced entry were noted. The decedent had a known history of metastatic prostate cancer and had previously expressed suicidal ideation.

TECHNIQUE AND IMAGING FINDINGS: Post-mortem CT-scan (PMCT) allowed precise visualization of entrance and exit wounds, fractures, bullet paths, and hemorrhagic patterns. The fractures from the second shot stopped against the fractures from the first shot, revealing the direction and chronology of the injuries: a non-lethal submental gunshot followed by a fatal right temporal shot.

DISCUSSION: This case highlights the forensic value of PMCT in determining the chronological order of gunshot wounds. The imaging confirmed the cause of death and established the sequence of injuries, crucial for medico-legal investigations.

CONCLUSION

PMCT provides non-invasive, high-resolution insights into bone trauma. In cases of multiple self-inflicted gunshots, it can help establish the precise chronology of injuries, supporting forensic analysis.