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A Journal on Forensic Medicine
Minerva Medicolegale 2002 March;122(1): 37-52
Further injurious marks made by objects resting on the skin close to a gunshot exit wound. A case report
Iesurum A., Romanelli M.
The authors report the case of a deadly gunshot wound in which one bullet perforated the neck and exited in the basal right-hand region of the neck. Soon after exiting, the bullet grazed the skin of the supraclavicular and homolateral deltoid region. On the upper part of the wound, there was a small exit wound made by a secondary bullet which was probably osseous in nature. Further above this, there were four patterned ecchymoses arranged in a series, in a sagittal layout and parallel to one another: the two lower ones were compatible in size and shape with a thin leather necklace worn by the victim, and the two upper ones were unmistakably made by a metal necklace which had also been worn rather tightly around the victim's neck. In particular, the authors analyse the etiopathogenesis of the double pair of patterned ecchymoses. The explanation they give is the impact made by the two bullets exiting the skin and pushing it out against the trinkets, since they were both very close to the exit wounds. They think that the bone fragment, resulting from the formation of a semi-channel in the anterior surface of the body of the fifth cervical vertebra, was the first to leave the body. It was followed soon after by the bullet exiting alongside it, thus justifying the formation of the two pairs of patterned ecchymoses made by the two trinkets. The authors also believe that a similar mechanism might explain the formation of ecchymosis halos around exit holes where the skin is covered by clothes and where these clothes represent supports for contusion.