Bullet
Bullet

• The entry wound is indicated by the white arrow.

• Notice the clean punched-out lesion.

• The entry wound tends to be small, since the bullet enters the body at high velocity and causes relatively little damage at the site of entry.


(Image Contrib. by:UCHC)(Description by: Melinda Sanders,M.D.)
T01000M11100
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Bullet wound
Etiology

•Guns and bullets of various kinds


Pathogenesis

• Transmission of kinetic energy to tissue; force equals 1/2 the product of mass and velocity squared.

• Injury depends on how much force is applied over how much area to what kind of tissue.

• Energy from the bullet will be spread along its path, not just at the entry point


Epidemiology

• Epidemic problem in the U.S. with >30,000 deaths/annum

• Particular problem in children (accidental deaths) and young adults (homicide)


Clinical

•Can be lethal.

•Skin wounds usually not the major cause of morbidity or mortality


General Gross Description

•The entrance wound is usually smaller than the exit wound, and smaller than the caliber of the bullet.

•Depending upon the distance between the weapon and the victim, an entrance wound can show evidence of burns.

•Additionally, small particulate injuries due to embedding of burned powder and unburned powder, etc. can be seen at the entrance wound.

•The exit wound is usually significantly larger than the bullet due to the slowing of bullet during transit, non-linearity of motion, as well as accretion of tissue from within the victim that might exit with the bullet.


General Micro Description

•Histologically, the wounds are characterized by laceration and destruction of tissue and significant hemorrhage.


Reference

• Robbins Pathologic Basis of Disease, 7th ed., 2005, pp. 444.


• Current literature from PubMed at National Library of Medicine


Synopsis by: T.V.Rajan, M.D., Ph.D., UCHC
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