A case of autopsy discovery of acute chest syndrome triggered by pulmonary embolism in a sickle cell patient.

This is a case report about a 7-year-old male child with sickle cell anemia (S/ß+) who died unexpectedly during hospitalization, justifying the performance of a forensic autopsy completed by histological examination of organ fragments and toxicological analyses of biological fluids. The diagnosis retained was pulmonary thromboembolism as the cause of death occurring in the context of an acute chest syndrome (ACS). The mechanism of occurrence of this pulmonary embolism was vascular stasis caused by sickle cell disease. The search for etiologies of ACS complicating sickle cell disease should not exclude pulmonary embolism with red cell dense fibrin clot..

[Medico-legal aspects of deaths by mechanical asphyxia occurring in Abidjan from 2002 to 2020]. / Aspects medico-legaux des morts par asphyxies mecaniques survenues a Abidjan de 2002 a 2020.

AIM: The aim of this work was to describe the deaths by mechanical as phyxiation that occurred in Abidjan in order to contribute to their prevention. MATERIAL AND METHODS: This was a retrospective and descriptive study carried out over a period of 19 years (2002-2020) and relating to deaths by mechanical asphyxia treated by Forensic Medicine. RESULTS: Deaths by mechanical asphyxiation represented 1.23% (756/60,984), concerned men (85%), from the informal sector (39.7%) or pupils/students (34.1%), single people (75%). These deaths occurred on Wednesdays (16.7%), in the afternoon (47.9%), during the month of June (15.2%), by drowning (72.2%), during swimming (56%). The hanging (15.1%) was discovered at the victim's home (95.6%) and the contexts that occurred were financial problems (26%) and depression (25%). Choking (11.4%) followed landslides (79%). Strangulation (1.3%) was criminal (100%) and occurred in the context of settling scores (60%) and crimes of passion (40%). The circumstances of occurrence of drowning and suffocation were accidental respectively in 71.8% and 82.6% of cases while hanging was suicidal (85%). CONCLUSION: Deaths by mechanical asphyxiation although minimal, constitute a social drama. Their prevention requires the implementation of preventive measures against drowning.

BUT: Ce travail avait pour but de décrire les morts par asphyxies mécaniques survenus à Abidjan en vue de contribuer à leur prévention. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude rétrospective et descriptive réalisée sur une période de 19 ans (2002- 2O20) et portant sur les morts par asphyxies mécaniques pris en charge par la Médecine Légale. RÉSULTATS: Les morts par asphyxies mécaniques représentaient 1,23%(756/60984), concernaient les hommes(85%), issus du secteur informel (39,7%) ouélèves/étudiants(34,1%), célibataire(75%). Ces décès survenaient les mercredis (16,7%), dans l'après-midi(47,9%), pendant le mois de Juin(15,2%), par noyade(72,2%), lors des baignades (56%). La pendaison(15,1%) était découverte au domicile de la victime(95,6 %) et les contextes de survenus étaient les problèmes financiers(26%) et la dépression(25%). Les suffocations(11,4%) faisaient suites aux éboulements de terrain(79%). La strangulation(1,3%) était criminelle (100%) et survenait dans les contextes de règlements de compte(60%) et de crimes passionnels(40%). Les circonstances de survenue des noyades et des suffocations étaient accidentelles respectivement dans 71,8% et 82,6% des cas alors que la pendaison était suicidaire(85%). CONCLUSION: Les morts par asphyxies mécaniques bien que minimes, constituent un drame social. Leur prévention passe par la mise en place des mesures de prévention contre les noyades.