An unusual exit wound as a result of a shotgun suicide to the head.

The location of a gunshot entrance wound as well as the wound path trajectory are the main findings that help to determine the position from which a weapon was fired and thus distinguish firearm suicides from homicides and accidents. We present a case of a 28-year old man, who was found dead in his car. Because of an unusual position of the firearm, which was clamped into the steering wheel, and an unclear entrance/exit wound, an autopsy was performed. The deceased showed typical signs of a contact shotgun wound to the head with an entrance wound in the right temporal region and an exit wound in the midface. With the help of gunpowder attachments and a muzzle imprint at the entrance site, a wound channel from the right lower posterior part of the temporal region to the left anterior part of the mid-facial region could be reconstructed. The stellate wound in the midface was assessed as an atypical exit wound. The cause of death was a contact shotgun shot to the right temple with a consequent central regulatory failure due to extensive brain injury. The manner of death was concluded to be a suicide.