Self-inflicted gunshot wound mimicking assault: a rare variant of factitious disorder

A Self-Inflicted Gunshot Wound With an Unusual Hand Injury

Self-inflicted gunshot wounds are a common cause of firearm-related deaths. The appearance and location of the entry wound, other concomitant findings at autopsy, and correlation with the scene and circumstances are critical in determining the manner of death. A case of a 72-year-old man with a self-inflicted gunshot wound with an unusual injury pattern is described. There was a contact range gunshot entry in the right temple, and an exit wound was seen in the left parietal region. There was a re-entry with an associated exit wound on the left hand.

Self-infliction of faked gunshot wounds in absence of overt psychopathology

Distinguishing deliberate self-inflicted body damage from assault represents a challenge to the forensic expert. Identifying a wound as self-inflicted can be particularly difficult in emergency room situations. We present the case of an individual who self-inflicted three bullet wounds, allegedly related to a shooting incident. This individual was lacking any overt psychopathology. When confronted with the facts, he confessed and explained his motivation. It is known that self-mutilation behavior can be related to particular, well systematized psychiatric disorders. However, in the absence of such a diagnosis, every suspicious wound should be carefully considered by the forensic expert as potentially self-inflicted with the intent by the "victim" of obtaining secondary gains.