An unexpected finding after robotic subtotal gastrectomy: Vomiting of Taenia Saginata.

INTRODUCTION: Most Human taeniasis are asymptomatic or associated with vague clinical manifestations, but cases of unusual migration of these parasites have been described. PRESENTATION OF A CASE: A case of challenging diagnosis of human Taenia Saginata infection is here presented: during COVID-19 pandemic we performed a mininvasive robotic subtotal gastrectomy for gastric angulus adenocarcinoma. 10 h after the end of the operation the patient presented an episode of vomiting with expulsion of a 5-meter-long adult form of Taenia Saginata. DISCUSSION: Parasitic infections are more frequent in the developing countries; in our case the transposition of small intestinal loop surely promoted the migration of Taenia Saginata through the gastro-jejunal anastomosis into the gastric stump.Preoperative evaluation (history, physical examination and imaging features) led to gastric cancer diagnosis and hindered the recognition of the taeniasis because of similar clinical presentations and the need to start quickly a therapeutic oncological strategy. CONCLUSION: Even if these cases are exceptional especially in Western Europe, it is important to obtain a detail clinical history and exclude parasitic infection as a cause of loss of weight and gastrointesinal abnormalities.

To analyse a trace or not? Evaluating the decision-making process in the criminal investigation.

In order to broaden our knowledge and understanding of the decision steps in the criminal investigation process, we started by evaluating the decision to analyse a trace and the factors involved in this decision step. This decision step is embedded in the complete criminal investigation process, involving multiple decision and triaging steps. Considering robbery cases occurring in a geographic region during a 2-year-period, we have studied the factors influencing the decision to submit biological traces, directly sampled on the scene of the robbery or on collected objects, for analysis. The factors were categorised into five knowledge dimensions: strategic, immediate, physical, criminal and utility and decision tree analysis was carried out. Factors in each category played a role in the decision to analyse a biological trace. Interestingly, factors involving information available prior to the analysis are of importance, such as the fact that a positive result (a profile suitable for comparison) is already available in the case, or that a suspect has been identified through traditional police work before analysis. One factor that was taken into account, but was not significant, is the matrix of the trace. Hence, the decision to analyse a trace is not influenced by this variable. The decision to analyse a trace first is very complex and many of the tested variables were taken into account. The decisions are often made on a case-by-case basis.

Utility of the clue - From assessing the investigative contribution of forensic science to supporting the decision to use traces.

In an attempt to grasp the effectiveness of forensic science in the criminal justice process, a number of studies introduced some form of performance indicator. However, most of these indicators suffer from different weaknesses, from the definition of forensic science itself to problems of reliability and validity. We suggest the introduction of the concept of utility of the clue as an internal evaluation indicator of forensic science in the investigation. Utility of the clue is defined as added value of information, gained by the use of traces. This concept could be used to assess the contribution of the trace in the context of the case. By extension, a second application of this concept is suggested. By formalising and considering, a priori, the perceived utility of using traces, we introduce the notion of expected utility that could be used as decision factor when choosing which traces to use, once they have been collected at the crime scene or from an object in the laboratory. In a case-based approach, utility can be assessed in the light of the available information to evaluate the investigative contribution of forensic science. In the decision-making process, the projection or estimation of the utility of the clue is proposed to be a factor to take into account when triaging the set of traces.

3D bloodstain pattern analysis: ballistic reconstruction of the trajectories of blood drops and determination of the centres of origin of the bloodstains.

For crime scene investigation in cases of homicide, the pattern of bloodstains at the incident site is of critical importance. The morphology of the bloodstain pattern serves to determine the approximate blood source locations, the minimum number of blows and the positioning of the victim. In the present work, the benefits of the three-dimensional bloodstain pattern analysis, including the ballistic approximation of the trajectories of the blood drops, will be demonstrated using two illustrative cases. The crime scenes were documented in 3D, using the non-contact methods digital photogrammetry, tachymetry and laser scanning. Accurate, true-to-scale 3D models of the crime scenes, including the bloodstain pattern and the traces, were created. For the determination of the areas of origin of the bloodstain pattern, the trajectories of up to 200 well-defined bloodstains were analysed in CAD and photogrammetry software. The ballistic determination of the trajectories was performed using ballistics software. The advantages of this method are the short preparation time on site, the non-contact measurement of the bloodstains and the high accuracy of the bloodstain analysis. It should be expected that this method delivers accurate results regarding the number and position of the areas of origin of bloodstains, in particular the vertical component is determined more precisely than using conventional methods. In both cases relevant forensic conclusions regarding the course of events were enabled by the ballistic bloodstain pattern analysis.

3D documentation of footwear impressions and tyre tracks in snow with high resolution optical surface scanning.

The three-dimensional documentation of footwear and tyre impressions in snow offers an opportunity to capture additional fine detail for the identification as present photographs. For this approach, up to now, different casting methods have been used. Casting of footwear impressions in snow has always been a difficult assignment. This work demonstrates that for the three-dimensional documentation of impressions in snow the non-destructive method of 3D optical surface scanning is suitable. The new method delivers more detailed results of higher accuracy than the conventional casting techniques. The results of this easy to use and mobile 3D optical surface scanner were very satisfactory in different meteorological and snow conditions. The method is also suitable for impressions in soil, sand or other materials. In addition to the side by side comparison, the automatic comparison of the 3D models and the computation of deviations and accuracy of the data simplify the examination and delivers objective and secure results. The results can be visualized efficiently. Data exchange between investigating authorities at a national or an international level can be achieved easily with electronic data carriers.