Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child

Suicide by a construction nail fired from a pistol

Penetrating head injury to accomplish suicide by a non-ammunition-related projectile discharged from a nail-gun is a very rare entity. The authors describe even much rarer, and the first reported case of a suicide penetrating head injury by a construction nail discharged from a blank cartridge of a pistol. The absence of beveling and muzzle impression, the non-ejection of the discharged cartridge, and the exit of just the tip of the nail from the other side of wound were the atypical features in this firearm fatality sustained at a contact-range. The entry wound prototypes like abrasion and grease collar, and blackening were absent. An improvisation to insert a construction nail into the chamber of firearm, for utilization as a projectile was another unique highlight here. The deceased was a construction builder. Being debt-ridden, he probably could not manage to purchase even one live cartridge for his licensee pistol to bring suicidal ideation to culmination.

Nail Gun Suicide: An Atypical Case Report and Review of the Literature

ABSTRACT

Nail guns are pneumatically driven or powder-actuated tools, which are used to drive nails into wood or concrete. A 42-year-old man, who was a builder by profession and history of antidepressant use, was found dead in his vehicle, holding a "Ramset" nail gun in his right hand. A straight metal nail and a book with a small hole were recovered from the scene.At autopsy, an irregularly circular puncture wound was seen on the forehead and a cruciate laceration was seen on the posterior aspect of the scalp. No burning, blackening, or tattooing was present around either injury. Both internal and external beveling was present with the latter being relatively larger. Toxicological analysis revealed alcohol and methamphetamine in blood. Psychiatric history and substance abuse must also be considered when individuals in construction industry are given access to tools like nail guns.Several unique features not previously reported were observed in this case. The deceased had overcome the built-in safety mechanism of the nail gun, by placing a book in between his forehead and muzzle. Another unique feature is that the nail had exited the cranium. Beveling, a feature commonly found in firearm injuries, was also seen in this case.

Penetrating chest injury afflicting coronary artery fistula-A delayed and asymptomatic occurrence

We present here a case of a symptomatic chest injury with a nail gun causing a delayed occurrence of coronary artery fistula to the left pulmonary artery presenting with unstable angina 4 years after the initial injury, three of which were symptom-free. The patient underwent successful surgical closure of the fistula and removal of the foreign body.

Double penetration wound: A nail gun injury involving the head and heart

Nail gun injuries usually occur at the extremities due to working accidents. Intracranial or intrathoracic injuries are relatively rare, and cases combined with both injuries are even rarer. Such situations pose challenges for surgeons due to their uniqueness during operation. Radiologic imaging findings in our case were significant in indicating surgical findings. Herein, we report a patient who shot himself using a nail gun, damaging his brain and heart.