Hidden shot pellets on postmortem computed tomography and their utilization for radiologic identification of decedents

We describe the case of a decomposed male cadaver found in an apartment who was transported to our institute for identification purposes. Computed tomography (CT) was performed to assess the possibility of a radiologic identification of the decedent (RadID) by dental implants or orthopedic implants. Surprisingly, the CT examination revealed seven spherical foreign bodies (diameter: 0.4 to 0.5 cm / 0.16 to 0.20 in) and one flat foreign body (diameter: 0.7 cm / 0.28 in; thickness 0.2 cm / 0.08 in) inside the cadaver. The foreign bodies were located extracranially in the soft tissue of the head (n = 1), the neck (n = 2), the abdomen (n = 2), the right upper arm (n = 1) and both thighs (n = 2) and were determined to be shot pellets according to their shape and high radiopacity. Immediately, the decedent was externally reexamined for entrance wounds according to the location of the shot pellets on CT. A thorough external examination revealed scarred entrance wounds on the head and neck. For the identification of the decedent, radiologic data from the renter of the apartment were requested from the municipal hospital. The radiology department provided a clinical CT scan of the abdomen of the suspected person, a 70-year-old man. An antemortem abdomen CT also demonstrated two shot pellets at the same location in the body. The decedent was radiologically identified by comparing the position of the retained shot pellets on antemortem and postmortem computed tomography. This case report presents a rare case of numerous retained shot pellets and the extraordinary RadID based on these retained shot pellets, which were only revealed because a postmortem CT scan was performed.