Suicidal Intra-Oral Gunshot with Labial Laceration

Case Report

Austin J Forensic Sci Criminol. 2017; 4(2): 1064.

Suicidal Intra-Oral Gunshot with Labial Laceration

Pierucci G¹, Toni C²* and Filomena C²

¹Department of Legal Medicine, University of Pavia, Italy

²Department of Legal Medicine, University of Pisa, Italy

*Corresponding author: Toni C, Department of Legal Medicine, University of Pisa, Via Roma 55, Pisa, 56126, Italy

Received: June 05, 2017; Accepted: June 23, 2017; Published: July 07, 2017


This paper describes a case of suicide using intra-oral gunshot (7.65 mm gun), with the bullet going in through the throat, out through the nape, at an angle, from the bottom up and from front to back. In addition, there was also a non-ballistic injury, i.e. a laceration on the inside of the lower lip that dug a few millimeters into tiny, tight depressions, shaped like the tips of the lower incisors. In that area, the depressions were all broken and dislocated, as were the teeth. The lip injury, with a macroscopically lively appearance, did not show any additional marks of gunshot and had been caused by firm pressure in the oral cavity, due to detonation.

Such injuries must be distinguished from injuries caused by bullets when they are shot in: gunshot in or near the oral site can be, though rarely, suggestive of murder, and that’s why such method must be clearly distinguished from suicide methods.

Keywords: Suicide; Gunshot; Depression


Suicide using gunshot is a comparatively frequent event, especially in countries were gun laws are more relaxed, where such phenomenon has spread so much that such suicide method is now one of the most frequently observed [1].

In Italy, the highest number of deaths by gunshot happens in the south: a retrospective survey conducted at the Institute of Forensic Medicine of Bari (Puglia) from 1988 to 2003 found 717 deaths from gunshot injuries, 82 of which were suicides (11.5%), with 81 men (98.7%) and just one woman [2].

The site of self-inflicted wounds depends on the type of fire arm, the sex of the victim, and whether the victim is right- or left-handed [3]. The anatomic site that is most commonly shot at is the head, followed by the chest, then the abdomen [4].

As to the head, some authors find that the most frequently shot site is the right or left temple, depending on whether the victim is right- or left-handed [5], while others find it is the oral cavity [3]. The fact the victim’s sex affects the choice of anatomic site has been confirmed by Cohle [6] who in his study found that 88.9% of men kill themselves by shooting at their heads, versus 48.4% of women.

Some rare cases of murder through shooting into the mouth at close range have been reported too. The main difference is that murders use a different path and cause both lip and dental injuries. Such injuries can also occur in suicide, like this one. So, injuries need to be carefully observed to tell the difference. That’s why this is such an interesting case as an example of injuries that could fit in with methods, homicide and suicide.

Case Presentation

A 73-year-old man, a retired pharmacist who lived with his wife, suffering from depression, loath to see a doctor in self-treatment. Found one morning at 06:40 am by his wife, who, worried by the noise of gunshot coming from their bedroom, had rushed into the room. The body was lying down, in a “pool of blood”, as described by his wife, perpendicular to then-suite door.

The A&E medical staff alerted by the dead man’s wife found no pulse in the carotid or radial artery, tried the usual resuscitation, and declared him dead.

Forensic police took the weapon he had shot with, which was a semiautomatic gun, made by TANFOGLIO Giuseppe mod. GT 30, 7.65 mm parabellum, legally held by the owner, and found a bullet in the barrel and the magazine fitted in. The weapon was in the washbasin of then-suite.

Inspection of the body

A widely blood-stained, 167 cm long male body.

Wearing: grey pyjamas, also widely blood-stained.

Treatment: oro-pharyngeal airway fitted in and electrodes in the usual and marks.

Minor bruising in both eye lids. Bleeding from both ears, more on the left. Partly clotted blood at the mouth and nose openings.

Warped tip of the head, extending on both sides to the occipital walls, with noticeable bone “step”. Just right of the median, near the junction with the occipital wall, the scalp shows a star-shaped gap (approximately 4 x 4 cm), with blood-soaked edges, which goes deeper in, with a bone breach oozing pulpy, bloody brain matter (Figure 1).