Homicide due to gunshot wound to the shank and shoulder with arterial bullet embolization

Penetration of the bullet into the vascular bed in a gunshot wound resulting in embolism is rarely described in the medical literature. Bullet embolism may be a diagnostic and therapeutic challenge and a source of serious subsequent complications. The aim of this paper is a case report of a criminal assault on a 67-year-old man who sustained two fatal gunshot wounds during the robbery. An autopsy revealed a large comminuted fracture of the right humerus with destruction and massive bleeding to the soft tissues, damage to the a. axillaris dextra with bullet embolism in the bifurcation area of a. iliaca communis sinistra and a comminuted fracture of the left tibiae with destruction and massive bleeding to the soft tissues. The cause of death was haemorrhagic shock due to massive external bleeding. The victim was not affected by foreign substances. Whole-body examination by imaging methods within autopsy is necessary even in seemingly trivial peripheral gunshot wounds to the extremities.