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This review article highlights the crucial role of organ weights and dimensions as key indicators in forensic diagnosis. Organ weight changes serve as valuable markers for pathological conditions, aiding forensic doctors in interpreting autopsy findings. The review emphasizes the importance of precision in establish- ing organ reference values, considering factors like population-specific norms and correlations with body parameters. Furthermore, it explores the impact of obesity on organ weights, emphasizing the need for updated databases that accurately reflect diverse populations. The article underscores the inadequacy of relying on outdated sources and advocates for creating a comprehensive and updated database of organ weights and dimensions for the local population, essential for accurate forensic interpretations.
Assuntos
Autopsia , Humanos , Tamanho do Órgão , Valores de Referência , AdultoRESUMO
This review delves into the forensic utility of the sternum in creating a biological profile, focusing on sex, stature, and age estimation. Emphasizing the sternum's significance in challenging scenarios, the study supports the combined length of the manubrium and sternal body as a crucial indicator in sex and stature estimation. However, it highlights the need for caution in applying findings across diverse populations and questions the reliability of Hyrtl's law. Age estimation, primarily based on morphological changes and ossification ages, is explored, with one study showing promise but requiring further validation. While acknowledging the sternum's advantages, the review underscores potential limitations and the absence of specific studies on ancestry estimation, leaving this aspect open for future research. In conclusion, the review provides a comprehensive overview of the sternum's forensic applications, urging continued research to enhance accuracy and applicability.
Assuntos
Antropologia Forense , Esterno , Esterno/anatomia & histologia , Humanos , Antropologia Forense/métodos , Determinação da Idade pelo Esqueleto/métodos , Masculino , Estatura , Determinação do Sexo pelo Esqueleto/métodos , FemininoRESUMO
A complex suicide defines a combination of multiple suicidal methods the victim successively or concurrently carries out. We present a case of a 72-year old man found dead on the railtrack, seemingly committing simple train-related suicide. Flobert revolver - a small caliber handgun was found nearby. Herein, we emphasize the significance of a thorough external examination, stress the fact that victim can act after low-energy projectile trauma and match our case to a similar complex suicide.
Assuntos
Armas de Fogo , Traumatismos Cranianos Penetrantes , Suicídio , Ferimentos por Arma de Fogo , Masculino , Humanos , Idoso , Ferimentos por Arma de Fogo/diagnósticoRESUMO
Suicidal behavior is multifaceted and encompasses various factors. Among these, alcohol dependence and acute alcohol intoxication stand out as significant risk factors for suicide. The retrospective study aimed to record the development of suicide, also in connection with alcohol consumption, in the catchment area of the Department of Forensic Medicine and Pathological Anatomy of the Health Care Surveillance Authority in Martin, Slovak Republic, in the years 2009-2019.
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Intoxicação Alcoólica , Alcoolismo , Suicídio , Humanos , Autopsia , Estudos Retrospectivos , Eslováquia/epidemiologia , Alcoolismo/epidemiologiaRESUMO
Autoerotic deaths refer to fatalities occurring during individual, solitary sexual activity, in which some device, situation, or act is used to gain or boost the sexual arousal of the subject. Anorectal autoeroticism is an autoerotic paraphilic activity that pertains to the self-insertion of various objects into the anal canal and rectal cavity to gain or heighten the subject's sexual drive. Although most foreign bodies inserted into the rectum do not cause significant injury, the introduction of some objects into the rectum might have unpredictable and even fatal effects. In this paper, we describe an intriguing autoerotic case of a 35-year-old male who sustained an explosive rectal trauma as a result of the unanticipated bursting of an expandable rubber pipe stopper that he inserted into his rectum and hyperinflated via an air blow gun connected through a pressure pipe to a centralized air-distribution system. The man sustained a circular abruption of the rectum with partial avulsion of the abdominal wall, associated with bleeding into the abdominal cavity and chest wall, and died before admission to the hospital. A police investigation revealed that the victim was a regular contributor to several web forums dedicated to unusual sexual activities. This case raises awareness of the broadening spectrum of methods and experiments associated with autoerotic behavior. We also reviewed the literature pertaining to this topic and outlined some of the characteristics of atypical autoerotic deaths. Although certain autoerotic methods are relatively common, other unusual autoerotic techniques may present novel challenges within the medicolegal field.
Assuntos
Traumatismos por Explosões/patologia , Explosões , Masturbação , Reto/lesões , Acidentes , Adulto , Embolia Aérea/patologia , Evolução Fatal , Corpos Estranhos/complicações , Humanos , Masculino , Pneumotórax/patologia , Reto/patologiaRESUMO
Electricity is a modern technology that can be used as method of suicide. Authors presents three cases of suicidal electrocution. The first case is a 55-year-old man who wrapped his chest and arms with electrically active wires connected to a timer. In second case, a 69-year-old man constructed electric mechanism from a disassembled extension cord. The last case describes a 53-year-old woman who was found dead in a water-filled bathtub.
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Traumatismos por Eletricidade , Suicídio , Idoso , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa , Ideação SuicidaRESUMO
Autoerotic death is a rare but recurring phenomenon in forensic medicine. This article presents two cases of unusual autoerotic death with signs of autoerotic asphyxia. Although the first case appeared to be asphyxia, the autopsy confirmed natural cause of death during solitary sexual activity of 69-year-old man found with exposed and bandaged genitals. The other case was asphyxiation utilizing a plastic bag and multiple panties wrapped around the head of 18-year-old man disguised in women´s dress.
Assuntos
Asfixia/mortalidade , Transtornos Parafílicos/mortalidade , Comportamento Sexual , Adolescente , Idoso , Asfixia/etiologia , Autopsia , Medicina Legal , Humanos , Masculino , Transtornos Parafílicos/patologiaRESUMO
Multiple sclerosis, currently incurable and potentially profoundly disabling demyelinating central nervous system disease, is associated with higher occurrence of suicide as affected individuals are prone to major depression and psychosis. Despite progressively incapacitating neurologic impairment, well-staffed institutions, and limited repertoire of methods of suicide, which prevents patients from purposefully ending their lives, suicide-determined patients typically commit suicide resulting from a medication overdose, sharp force traumata, self-neglect, or deliberate starvation. Here we describe a successful suicide committed by a 39-year-old wheelchair-bound, institutionalized, quadriparetic male patient with a diagnosis of multiple sclerosis with secondary progressive clinical course who utilized his motorized wheelchair to terminate his life. He tied a rope between his neck and wall bars and then propelled the wheelchair forwardly. The acceleration of the wheelchair resulted in ligature self-strangulation. This case report, with a review of the literature, is noteworthy for the rareness of the wheelchair-related fatality combined with an unusual, if not entirely unseen, suicidal mechanism in severely disabled adult.
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Asfixia/patologia , Pessoas com Deficiência , Lesões do Pescoço/patologia , Suicídio Consumado , Cadeiras de Rodas , Adulto , Humanos , Institucionalização , Masculino , Esclerose Múltipla , QuadriplegiaRESUMO
The concept of spontaneous combustion has huge appeal as an historical fiction but it has no scientific background. However, in some deaths involving fire, a body can burn away virtually completely with minimal thermal destruction to the neighboring environment. We report an extraordinary case of the self-immolation of an elderly woman who set herself on fire with suicidal intentions. The unusual appearance and location of the body closely resembled the phenomenon of so-called spontaneous human combustion because the upper parts of the body were almost totally destroyed by fire, while the legs and surrounding structures remained almost untouched by flames. The results of all investigations proved that the woman set fire to her body using a box of matches and accelerants (concentrated ethanol and a solid firelighter). Near-total combustion of her body subsequently occurred during the postmortem period. The development of alleged spontaneous human combustion requires the following: ignition (external heat source), fuel (molten human fat), a wick (e.g. charred and porous clothing, bedding, or ground), time, and an optimal microclimate for gradual burning.
Assuntos
Queimaduras/patologia , Incêndios , Suicídio , Idoso de 80 Anos ou mais , Etanol , Feminino , Humanos , SolventesRESUMO
Geocaching is a high-tech treasure-hunt game that uses GPS-enabled devices or smartphone apps to find cleverly hidden treasures marked by GPS coordinates that are shared online. Like any other outdoor activity, geocaching is associated with risks of falls, environmental injuries, asphyxia and natural events. Despite the apparent risk of serious injury and potential death, no relevant reports aiming to identify the characteristics of geocaching-related deaths have appeared in the medical literature to date. We report a case of an experienced geocacher who was found suspended from a bridge pillar with his climbing ropes and helmet straps twisted across his face and neck; he had apparently attempted to rappel from a 30-m-high railway bridge to find a geocache. A recording of the rappelling sequence from the camera found on the chest strap assisted in reconstructing what had actually happened. An autopsy confirmed that the cause of death was asphyxiation due to hanging, with the occlusion of the external airways and positional asphyxia serving as contributory factors. The salient features of this unusual case are discussed, and several forensic issues of geocaching are highlighted.
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Asfixia/etiologia , Postura , Recreação , Asfixia/patologia , Sistemas de Informação Geográfica , Humanos , Masculino , Pessoa de Meia-Idade , SmartphoneRESUMO
Massive progress in developing even more precise imaging modalities influenced all medical branches including the forensic medicine. In forensic anthropology, an inevitable part of forensic medicine itself, the use of all imaging modalities becomes even more important. Despite of acquiring more accurate informations about the deceased, all of them can be used in the process of identification and/or age estimation. X - ray imaging is most commonly used in detecting foreign bodies or various pathological changes of the deceased. Computed tomography, on the other hand, can be very helpful in the process of identification, whereas outcomes of this examination can be used for virtual reconstruction of living objects. Magnetic resonance imaging offers new opportunities in detecting cardiovascular pathological processes or develompental anomalies. Ultrasonography provides promising results in age estimation of living subjects without excessive doses of radiation. Processing the latest information sources available, authors introduce the application examples of X - ray imaging, computed tomography, magnetic resonance imaging and ultrasonography in everyday forensic medicine routine, with particular focusing on forensic anthropology.
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Antropologia Forense , Medicina Legal , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Humanos , RadiografiaRESUMO
The postmortem diagnosis of hypothermia remains problematic even in the era of molecular and digital diagnostic advances. Gross hemorrhages in iliopsoas muscles have been regarded as a helpful diagnostic sign in hypothermia fatalities; nevertheless, they have received marginal attention since their original description. The present study attempts to fill that void by examining occurrence, localization, and diagnostic significance of the bleeding into the core muscles as evidence of death due to hypothermia in a series comprising 51 consecutive hypothermia autopsy cases. Hemorrhages into the core muscles were identified in 33 cases of fatal hypothermia (65%). Hemorrhages were present in iliopsoas muscles (19 cases; 37%), deep back muscles (18 cases; 35%), and in other core muscular groups such as the diaphragm, cervical, pectoral, and intercostal muscles (11 cases; 22%). The results of the study offer an attractive diagnostic opportunity and reaffirm the potential of the careful core muscle dissection for the clarification of hypothermic deaths. Centers lacking high-end imaging technologies and molecular postmortem programs may especially benefit, which may have implications in broader autopsy practice.
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Hemorragia/patologia , Hipotermia/patologia , Músculo Esquelético/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Células Epiteliais/metabolismo , Eritema/patologia , Feminino , Patologia Legal , Humanos , Túbulos Renais/patologia , Metabolismo dos Lipídeos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Líquido Sinovial , Membrana Sinovial/patologiaAssuntos
Seio Etmoidal/patologia , Hemorragia/patologia , Lesões do Pescoço/sangue , Idoso , Autopsia , Feminino , Patologia Legal , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
It is important that forensic pathologists are familiar with variations in the size and shape of the laryngohyoid complex when interpreting injuries and pathology of the head and neck region. Accurate postmortem examination of the laryngohyoid structures may be difficult if anatomical variation in these structures is present. Agenesis of the upper horns of the thyroid cartilage has medicolegal significance because it may be mistaken for a fracture or other trauma-related conditions. We present 3 cases with different forms of agenesis of the superior cornu of the thyroid cartilage, namely, right unilateral, left unilateral, and bilateral agenesis.
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Cartilagem Tireóidea/anormalidades , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Patologia Legal , Humanos , Masculino , Cartilagem Tireóidea/patologiaRESUMO
Despite the availability of modern imaging and molecular tools, traditional autopsy, and laboratory findings remain the gold standard for the diagnosis of drowning. This article presents two cases of freshwater drowning in which hemolytic staining of the endocardium of the left heart chambers was observed at autopsy. One case was a suicidal drowning of an 84-year-old man, and the other case was an accidental drowning of an 86-year-old woman. In both cases, there was marked hemolytic staining of the endocardium of the left atrium and ventricle. The endocardium of the right heart chambers was clear and transparent in appearance. Hemolytic intimal staining of the aortic root was observed in one case. Gettler's test was positive in both cases. Hemolytic discoloration of the endocardium of the left heart chambers after freshwater drowning is analogous to hemolytic staining of the aortic root. Both staining patterns result from the hypo-osmolar hemolysis that occurs in the left heart chambers and systemic circulation after hypotonic fluid passes across the alveolocapillary membrane. Hemolytic discoloration of the endocardium of the left heart chambers at autopsy may support a diagnosis of freshwater drowning.
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Afogamento/patologia , Endocárdio/patologia , Patologia Legal/métodos , Átrios do Coração/patologia , Ventrículos do Coração/patologia , Hemólise , Acidentes , Idoso de 80 Anos ou mais , Autopsia , Causas de Morte , Afogamento/sangue , Evolução Fatal , Feminino , Água Doce , Humanos , Masculino , Valor Preditivo dos Testes , SuicídioRESUMO
UNLABELLED: Ethanol is the main psychoactive ingredient of alcoholic beverages. Together with water it makes their major part. The other substances contained in alcoholic beverages are called congeners. Some of them come from the original substance of the beverage, some come from the fermentation or mellowing process. Except giving the drink its specific taste, scent and colour, congeners also have a non-negligible direct influence on the alcohol consumer. Nowadays, methods of identification thousands of alcohol congeners are available. Analyzing chemical compounds of alcoholic beverages have only recently gained its importance, when it helped to estimate the basic chemical composition of the particular alcoholic beverages. Mentioned method is able to identify an exact type of alcoholic beverage which a man consumed before the blood sample necessary for the detection had been taken from him. It becomes irreplaceable especially in forensic assessment of the drunkenness in case an alcoholised person, responsible for any crime, excuses himself that he was drinking only after the act/crime (e.g. traffic accident) had happened. It can also help to aprove/disprove a testimony of an accused person that he/she was unaware of being given alcohol into his/her non-alcoholic beverage. Development of the new chemical methods analyzing alcohol congeners are of a great benefit for any forensic expert-medical doctor dealing with the field of forensic alcohology. However, he/she must be aware that interaction of alcohol congeners with the human organism follows different laws in comparison to alcohol/ethanol itself. KEYWORDS: alcohol - congener - alcohol congener analysis - forensic alcohology.
Assuntos
Bebidas Alcoólicas/análise , Intoxicação Alcoólica/sangue , Medicina Legal/métodos , Intoxicação Alcoólica/diagnóstico , Etanol/sangue , Etanol/química , HumanosRESUMO
UNLABELLED: Alcohol accounts for a great amount of deaths per year either due to the acute intoxication or due to the secondary impacts of acute or chronic alcoholism. Commonly, in large amount of such fatal cases blood alcohol concentration is low or absent and fatty liver disease is frequently the only pathological finding detected at the autopsy of alcohol consumer. We offer a short case report of a case with the following analysis of why we decided to consider alcoholic ketoacidosis in our differential diagnosis. KEYWORDS: metabolic disturbance - alcoholic ketoacidosis - chronic alcoholism - sudden death.
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Power hammers are mechanised forging devices that constitute a pivotal part of steel manufacturing. Power hammer-associated injuries are a rare occurrence. We report a noteworthy case of a 52-year-old man who sustained a high-energy penetrating injury while working with a power (counterblow) hammer. The man used a sizable disc-shaped metallic object to dislodge the forging wedged in the machine by applying the force of the striking ram on it. On impact, the object ejected and struck the man in the right lateral portion of the chest. The autopsy disclosed extensive damage to the thoracic and abdominal organs. The cause of death was opined to be exsanguination due to penetrating trauma of the heart and transection of the descending aorta. The investigation confirmed a breach of safety regulations. To the best of our knowledge, this is the first power (counterblow) hammer-related fatality in medico-legal literature.