Vanishing Bullet Syndrome

Vanishing Bullet Syndrome

Here are ten forensic pathology scenarios where a gunshot entrance wound is visible externally, although no bullet is recovered at autopsy:
1. Through-and-through gunshot wound: Bullet enters chest and exits the back, leaving no projectile inside.
2. Craniofacial trajectory: Bullet enters the skull, passes through sinuses or cranial vault, and exits via mouth, nose, or ear.
3. Perforating neck wound: Bullet enters one side of the neck and exits on the opposite side (e.g., lateral trajectory through soft tissue).
4. Oral cavity exit: Bullet enters face/head, travels through maxilla/mandible, and exits via open mouth.
5. Base of skull exit: Bullet enters posterior skull, exits through foramen magnum or nasal cavity.
6. Thoracic exit: Bullet enters chest, perforates lung and diaphragm, and exits through abdominal wall or flank.
7. Pelvic trajectory: Bullet enters buttock/hip and exits through perineum or opposite buttock.
8. Limb perforation: Bullet enters arm or leg and exits on opposite side, often at close range.
9. Ricochet within body, then exit: Bullet strikes bone, deflects, and exits elsewhere (e.g., enters chest, deflects off rib, and exits lateral thoracic wall).
10. Iatrogenic removal: Bullet enters, but is surgically removed prior to death/autopsy (hospital intervention).

Here are ten less obvious, although still realistic forensic pathology scenarios where there is a clear entrance wound externally; however no bullet inside at autopsy:
1. Exit via natural orifice (anus/vagina/urethra): Bullet enters abdomen/pelvis, travels through hollow viscera, and is expelled through a natural body opening.
2. Exit via tracheostomy/medical opening: Bullet enters thorax/neck but later exits through a surgically created airway or drainage tract.
3. Projectile lost during resuscitation: Bullet lodged near wound tract but expelled during CPR, intubation, suctioning, or chest tube insertion.
4. Projectile regurgitated/vomited: Bullet enters pharynx, lodges temporarily, and is later expelled through vomiting or post-mortem purging.
5. Projectile swallowed and passed: Bullet enters oral cavity, lodges in pharynx/esophagus, then swallowed and passed into GI tract before death, not recovered at autopsy.
6. Projectile washed away post-mortem: Bullet enters craniofacial region, lodges loosely in oral/nasal cavity, and is lost during body transport, embalming, or washing.
7. Projectile displaced by animal/insect activity: Bullet in superficial wound tract removed by scavenging animals, insects, or decomposition processes.
8. Bullet exits via surgical drain site: Patient survives initial GSW, bullet migrates along soft tissue planes, and exits through drain or wound dehiscence site.
9. Projectile in body bag/clothing, not retained inside: Bullet enters and passes through, lodging in clothing or falling into the body bag rather than remaining inside the body.
10. Bullet migration and external expulsion: Bullet initially lodged in soft tissue migrates (gravity/movement), then extrudes spontaneously through skin or ulcerated wound tract before autopsy.

These scenarios highlight uncommon mechanisms where the absence of a bullet can puzzle investigators unless the full circumstances (medical interventions, body handling, decomposition, etc.) are considered.