RESUMEN
Age-at-death estimation is an important issue in forensic medicine and anthropology. Initially, methods relied on morphological criteria, but with the advancement of radiology, new techniques such as morphological studies on multi-slice computed tomography (CT) reconstructions have emerged. Recent studies have shown promising results by investigating the correlation between age and bone mineral density (BMD). However, there is currently a lack of data on post-mortem CTs (PMCT) involving decomposed bodies, and limited information exists regarding changes in Hounsfield Units measurement in a post-mortem context. In light of these gaps, our study aimed to examine the relationship between age at death and pubic and ilium BMD using a sample of forensic bodies. We also aimed to determine whether post-mortem processes, such as putrefaction, could interfere with this correlation. Our retrospective analysis encompassed 637 PMCTs conducted before medicolegal autopsies at Tours University Hospital. Utilizing simple and multiple linear regressions, we investigated the correlation between age and pubic and ilium BMD, as well as the relationship between BMD and the radiologic alteration index (RAI), a scale employed to quantify the degree of putrefaction. Our findings indicate promising outcomes in age-at-death estimation using pubic and/or ilium BMD for bodies exhibiting no or moderate decomposition (RAI < 80), particularly among individuals under 40 years old. However, for highly decomposed corpses (RAI ≥ 80), the presence of gas infiltration significantly influences the BMD of both the ilium and pubis. Consequently, we advocate for the incorporation of the RAI score into the age estimation equation to enhance the accuracy of our results in such cases. Further investigation involving a larger cohort of decomposed bodies could facilitate refinement and validation of our method within this specific population.
RESUMEN
Cases of battery ingestion are well documented in the scientific literature, especially concerning button cell battery ingestion in children. In this instance, the authors present an atypical case of a young man who voluntarily ingested a cylindrical alkaline battery containing manganese. The patient died approximately a week later, despite not exhibiting any specific symptoms. The battery was found in the cecum during the autopsy, showing deterioration at its positive pole. The cecal mucosa exhibited two ulcerations without perforation. Histological analysis revealed intestinal ischemia in the cecum, with no microscopic lesions in other organs. Toxicology reports indicated high levels of manganese in both cardiac and peripheral blood. Considering all the results from the additional analyses, the experts concluded that the death was likely of multifactorial origin, associated with a toxic blood concentration of manganese. To the best of our knowledge, this is the first recorded death following the ingestion of a cylindrical battery, and the first instance of manganese intoxication resulting from the ingestion of an alkaline battery. The authors will present the case and provide a literature review to assess the extent to which the presence of manganese may have contributed to the fatality.
RESUMEN
The Piton de la Fournaise, located on the island of Reunion, is a particularly active volcano that gathers many observers during its eruptions. However, this activity, if not supervised, can involve many risks. During the eruption of Piton de la Fournaise in April 2021, two geology students camped in the peri-eruptive zone. They were found dead 48 h later on the surface and were not in the immediate vicinity of a fumarole. The autopsy revealed superficial traumatic injuries, which did not explain the death. Internal examination of both victims showed a nonspecific asphyxia syndrome and hemorrhagic pulmonary edema, with no cause of death identified. Microscopic analysis confirmed the autopsy findings without providing new diagnostic elements. Toxicological analysis revealed abnormally high levels of sulfurous gases (H2 S and SO2 ) in the blood and lungs of both victims. The interpretation of all the forensic data allows us to conclude that the death was secondary to volcanic sulfur gas poisoning, despite the atypical context of this event. However, the meteorological conditions of the night of the event may have caused a stagnation of toxic volcanic gases on the ground, with concentrations high enough to cause fatal intoxication in these two persons, although they were not in a confined environment as is usually the case in cases of sulfur poisoning. The dramatic outcome of this event required a rigorous forensic diagnostic approach and reminds us of the need to respect safety conditions in peri-volcanic areas.