Medico-legal features of rifled weapons discharge fatalities in Rome (Italy) and analysis of the differences in internal bullet wound paths between suicide and homicide

Firearm wounds reppresent a significant cause of mortality worldwide. The differentiation between suicide, homicide, and accidental incidents can be complex, particularly in the absence of clear injuries linked to third-party involvement. Autopsy characteristics of wounds are pivotal in determining the manner of death. A review of the Institute of Legal Medicine of the University of Rome Tor Vergata's database identified 64 deaths due to rifled weapon discharge wounds, excluding accidental deaths. We recorded demographic, circumstantial, and autopsy data for homicides and suicides, with a focus on bullet intrasomatic wound paths analysis. Differences in frequencies of circumstantial data were observed, notably in the locations where victims’ bodies were discovered. Autopsy findings revealed distinct anatomical wound distribution. Bullet wound paths across three anatomical planes indicated patterns associated with the manner of death. Leftward, upward, and backward pathways were unique to suicides, while frontward and rightward pathways strongly indicated homicide. Therefore, comprehensive data integration is essential for accurate forensic diagnosis, and projectile directionality alone should not be considered a definitive criterion to distinguish between suicide and homicide, as similar wound paths may arise in both contexts depending on the circumstances.