Crossbow injuries: A case report with experimental reconstruction study and a systematic review of literature

Maiese, Aniello; Santoro, Paola; Russa, Raffaele La; Matteis, Alessandra De; Turillazzi, Emanuela; Frati, Paola; Fineschi, Vittorio

doi:10.1016/j.jflm.2021.102147

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…1 A review of crossbow injuries found a 69% mortality rate. 2 Homicide accounted for 53% of fatalities, suicide for 32%, and accidental injuries for 16%. Despite relatively minor external injuries, crossbow injuries can be devastating.…”

Section: Diagnosismentioning

confidence: 99%

“…From 2016–2020, the National Electronic Injury Surveillance System estimates there were an average of 4391 injuries from archery equipment annually, with no fatalities 1 . A review of crossbow injuries found a 69% mortality rate 2 . Homicide accounted for 53% of fatalities, suicide for 32%, and accidental injuries for 16%.…”

Section: Diagnosismentioning

confidence: 99%

“…JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians Computed tomography of the facial bones showing transection of the right optic nerve (asterisk)archery equipment annually, with no fatalities 1. A review of crossbow injuries found a 69% mortality rate 2. Homicide accounted for 53% of fatalities, suicide for 32%, and accidental injuries for 16%.Despite relatively minor external injuries, crossbow injuries can be devastating.ORCIDCindy C. Bitter MD, MPH https://orcid.org/0000-0002-2361-8394 JACEP Open 2021;2:e12596.…”

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Man with altered mental status

2021

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Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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Man with altered mental status

2021

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“…The crossbow, an ancient weapon [1] originating in China between the 8th and 5th centuries BC, played a crucial role as a defensive and offensive weapon in medieval military history [2], due to its accuracy and power. Over the years, it has been replaced by firearms [3], but it is still used today in competitive sports, such as hunting and target shooting [4].…”

Section: Introductionmentioning

confidence: 99%

A unique case of suicide by crossbow with indirect triggering and cranial injury: forensic issues and literature review

Stefano,

Guendalina,

Riccardo

et al. 2024

Forensic Sci Med Pathol

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Currently, crossbows are involved in some deaths, including suicides. These are rare events for which an accurate study of the body discovery site and reconstruction of the triggering mechanism of the crossbow represent crucial medicolegal elements. In this report, a unique case of suicide by crossbow is presented, in which the male victim constructed an elaborate scenario. He arranged two tripod stands to hold the crossbow at the height of his head, and a third to support a hollow tube positioned in front of the muzzle of the crossbow to direct the bolt. After positioning the center of the forehead in front of the hollow tube, the trigger was activated from a distance using a hooked metal rod. The methods used prompted a literature review on suicide by crossbow, which revealed only 14 reports from 1993 to 2023. The head and chest were the main target areas, and in almost all cases, the victims directly pulled the trigger with their finger. Only one case of indirect triggering was found, with the chest as the target. Therefore, in this scenario, the case presented stands as a unique report, due to the elaborate system devised to carry out the suicide and accurately strike the predetermined target.

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“…Penetrating chest trauma caused by crossbows is very rare and mostly reported as suicides, homicides, and accidental cases in forensic studies. According to a review of the literature regarding crossbow injuries, patients survived in only 17 of 55 cases (31%) [2] .…”

Section: Introductionmentioning

confidence: 99%

The diagnosis of delayed expanding traumatic pseudoaneurysm of thoracic aorta caused by self-inflicted penetrating injury with crossbow bolt: A case report

Nakamura

Yamada

Naito

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Penetrating chest trauma caused by a crossbow bolt is very rare. Herein, we report a successfully treated patient who attempted suicide by directing a crossbow to the chest cavity and developed an expanding pseudoaneurysm of the thoracic aorta during eight-day follow up. Case presentation A 51-year-old male was admitted to the emergency department after firing a crossbow bolt twice into his left chest. At admission, the patient was hemodynamically stable and maintaining oxygenation. The bolt had already been removed from the body. Contrast-enhanced computed tomography (CT) revealed a cavity pseudoaneurysm 2.5 mm in size in the aortic arch. Three-dimensional reconstruction of the CT demonstrated wound tracts showing probable damage by the bolt. The patient was admitted to the emergency department for careful observation and transferred to the psychiatric ward on day two. Follow-up contrast-enhanced CT on day eight demonstrated rapid expansion of the pseudoaneurysm from 2.5 mm to 4.0 mm in size. We performed thoracic endovascular aortic repair (TEVAR) on day 13. The patient was uneventfully discharged on the 20th hospital day. Clinical discussion Emergency physicians should be aware that damage to the surrounding tissue may be accompanied by delayed expansion of an aortic pseudoaneurysm, even if the bolts do not cause direct aortic wall injury. Conclusion This case suggests that understanding the injury mechanism, confirming the tract of the bolts, and carefully exploring traumatic pseudoaneurysm can lead to a less invasive operation due to early detection.

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Crossbow injuries: A case report with experimental reconstruction study and a systematic review of literature

Cited by 9 publications

References 37 publications

Man with altered mental status

Man with altered mental status

A unique case of suicide by crossbow with indirect triggering and cranial injury: forensic issues and literature review

The diagnosis of delayed expanding traumatic pseudoaneurysm of thoracic aorta caused by self-inflicted penetrating injury with crossbow bolt: A case report

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