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Bullet wound
Etiology

Man-made injury
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.,
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.
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.
•Examples:
tract of cardiac bullet wound
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.
•Examples:
References

1.Adelson, L. The Pathology of Homocide. Springfield: Thomas, 1974, pp.268-270.

For Most Current Information Search Medline at National Library of Medicine
This link will directly take you to the relevant new literature
Bullet wound
Synopsis by: J. Hasson, MD (T32000E94710)[338]
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