| Bullet wound
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Etiology
•Man-made injury
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Pathogenesis
•Perforation of the pericardium and adjoining pleura
results in a massive hemorrhage into the pericardial
sac draining into the pleural cavity, with death due
to exsanguination.
•A bullet tract which perforates the pericardium
and heart without communication with a pleural cavity
results in instantaneous death due to cardiac
tamponade.,
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Epidemiology
•Epidemic in the United States with >30,000 deaths/annum.
•Particular problem in children (accidental) and young adults (homicide)
•(Opinion) Factors include poverty, drugs, escalation
of frequency and intensity of television and motion
picture violence, Civil Liberties Union and the
National Rifle Association.
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General Gross Description
•The bullet tract can involve any of the anatomical
components of the heart.
•The wounds in the wall are larger, when the
perforation occurs in a chamber in diastole.
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General Microscopic Description
•Disruption and fragmentation of the tissues are seen
with extensive interstitial hemorrhage in the tissues
adjoining the tract.
•Early infiltration of neutrophils may be seen in
cases surviving for a matter of a few minutes, when
there is a pericardial drainage into the pleural
cavity.
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Clinical Correlation
•Every scenario is unique, a "singularity".
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References
•1.Adelson, L. The Pathology of Homocide.
Springfield: Thomas, 1974, pp.268-270.
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| Bullet wound
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| Synopsis by: J. Hasson, MD (T32000E94710)[338]
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