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The crucial role played by material trace analysis in resolving a murder vs. suicide dilemma 物质痕迹分析在解决谋杀与自杀的困境中所起的关键作用。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-16 DOI: 10.1111/1556-4029.15690
Dora Domnica Baciu PhD, Bogdan Alexandru Tașbac PhD, Roxana Trușcă PhD, Dan Eduard Mihăiescu PhD Eng

In the case of a young woman's death by falling from the window of her boyfriend's sixth-floor apartment, investigators needed to determine whether the fall was suicidal or if the victim was forcibly pushed. The incident occurred at night, with her boyfriend being the only witness to how the fall happened. Establishing the origin of the material traces found on the woman's stockings and shoes, along with other clues, played a crucial role in resolving this dilemma. The traces found on the stockings and samples collected from the building's external wall were analyzed using digital stereomicroscopy, High-resolution scanning electron microscopy (HRSEM) coupled with energy dispersive X-ray spectroscopy (EDX), and optical microscopy. Chlorophyll presence on both the victim's stockings and the surface of the building façade was confirmed using Raman spectroscopy. The inorganic traces found on the shoes and the external wall were examined using stereomicroscopy and HRSEM coupled with EDX and were found to be similar in texture and elemental composition. The correspondence between the biological structures and mineral fragments, along with the dynamic friction marks found on the woman's body and shoes, confirmed physical contact between the victim and the external wall. These findings led to the conclusion that the victim struggled for her life and the fall resulted from a criminal act.

在一名年轻女性从其男友六楼公寓的窗户坠下死亡的案件中,调查人员需要确定受害者是自杀还是被强行推下。事件发生在夜间,她的男友是坠楼过程的唯一目击者。确定在该女子的丝袜和鞋子上发现的物质痕迹的来源以及其他线索,对解决这一难题起到了至关重要的作用。我们使用数字立体显微镜、高分辨率扫描电子显微镜(HRSEM)和能量色散 X 射线光谱仪(EDX)以及光学显微镜对丝袜上发现的痕迹和从大楼外墙采集的样本进行了分析。拉曼光谱法证实了受害者的丝袜和建筑物外墙表面都含有叶绿素。使用体视显微镜和 HRSEM 以及 EDX 对鞋子和外墙上发现的无机物痕迹进行了检查,发现其质地和元素组成相似。生物结构与矿物碎片之间的对应关系,以及在该女子身体和鞋子上发现的动态摩擦痕迹,证实了受害人与外墙之间的身体接触。这些研究结果得出的结论是,受害者在生命线上挣扎,坠楼是犯罪行为所致。
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引用次数: 0
Potential postmortem microbial biomarkers of infant and younger children death investigation 婴幼儿死亡调查中潜在的死后微生物生物标志物。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-16 DOI: 10.1111/1556-4029.15677
Bethany Mikles MS, Carl J. Schmidt MD, MPH, M. Eric Benbow PhD, Heather R. Jordan PhD, Jennifer L. Pechal PhD

Microbial communities associated with the human body are highly dynamic and reflect the host environment and lifestyle over time. Studies show death is no exception, with data demonstrating similar antemortem and postmortem microbiomes up to 48 h following death. These predictable microbial biomarkers can inform death investigation by helping to estimate the postmortem interval and build models to identify cause and manner of death. However, no attempts have been made to model potential microbial biomarkers in pediatric (≤2 years) deaths. This study provided a cross-sectional survey of the microbiota of 53 pediatric cases (black, white, both sexes) seen in Wayne County, Michigan. Autopsy cases represented accidents, homicides, or natural causes. Postmortem microbiome were collected by swabbing the eyes, ears, nose, mouth, umbilicus, brain, rectum, trabecular space, and cardiac blood. 16S rRNA sequence analyses indicated that sex, race, age, body site, and manner of death (MOD) had significant effects on microbiome composition, with significant interactions among MOD, race, and age. Amplicon sequence variants identified intra- and interhost dispersion of the postmortem microbiome depending on death circumstance. Among manners of death, non-accidental deaths were significantly distinct from all other deaths, and among body sites the rectum was distinct in its microbial composition. There is a real need for robust postmortem microbiome before it can be standardized as a practical tool for use in forensic investigation or public health. These results inform postmortem microbial variability during pediatric death investigation that contributes to a larger effort to understand the postmortem microbiome.

与人体相关的微生物群落是高度动态的,反映了宿主环境和生活方式的长期变化。研究表明,死亡也不例外,有数据显示死前和死后微生物群落相似,最长可达死后 48 小时。这些可预测的微生物生物标志物可为死亡调查提供信息,帮助估计死后间隔时间并建立模型以确定死亡原因和方式。然而,目前还没有人尝试对小儿(≤2 岁)死亡的潜在微生物生物标志物进行建模。本研究对密歇根州韦恩县 53 例儿科病例(黑人、白人、男女均有)的微生物群进行了横断面调查。尸检病例包括事故、凶杀或自然死亡。通过拭取眼、耳、鼻、口、脐、脑、直肠、小梁间隙和心血收集了死后微生物组。16S rRNA 序列分析表明,性别、种族、年龄、身体部位和死亡方式(MOD)对微生物组的组成有显著影响,MOD、种族和年龄之间存在显著的交互作用。扩增子序列变异确定了死后微生物群在宿主内和宿主间的分散性,这取决于死亡情况。在死亡方式中,非意外死亡与所有其他死亡明显不同,而在尸体部位中,直肠的微生物组成也与众不同。在将死后微生物组标准化为用于法医调查或公共卫生的实用工具之前,确实需要对死后微生物组进行强有力的研究。这些结果为儿科死亡调查过程中的死后微生物变异提供了信息,有助于了解死后微生物组的更大努力。
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引用次数: 0
Performance evaluation of a Cadre Forensics TopMatch-GS 3D system for cartridge case comparisons 用于弹壳比较的Cadre Forensics TopMatch-GS 3D系统的性能评估。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-12 DOI: 10.1111/1556-4029.15688
Joseph W. Alsdurf MS, Eric F. Law PhD, Stephanie C. Luehr MS

Three-dimensional (3D) measurement systems for firearm forensics are becoming more prevalent in forensic laboratories, and these instruments are typically coupled with algorithms to assist firearm examiners with comparisons. Due to differences in firearm feature reproducibility on different types of ammunition, comparison algorithms need to be tested utilizing a variety of ammunition brands. For this study, 30 shots were fired, utilizing six common ammunition brands, from each of the 10 casework firearms for a total of 300 cartridge cases. All cartridge cases were scanned on a Cadre Forensics TopMatch-GS 3D desktop system and compared using Cadre's breech face and firing pin aperture shear algorithms for a total of 44,850 comparisons. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to quantify the performance of the algorithms when comparing within and between ammunition brands. Same ammunition brand comparisons (AUC = 0.964) performed statistically significantly better (p = 0.0075) than different ammunition brand comparisons (AUC = 0.944). Overall, the results generally indicated greater reproducibility of characteristics from a firearm when the ammunition in a comparison is the same, however, Cadre's algorithms demonstrated excellent overall discrimination between same and different-source comparisons regardless of ammunition brand (AUC = 0.946). Additionally, score thresholds were evaluated for easier interpretation of what algorithm results mean for practitioners, where 68.6% of same-source comparisons resulted in a similarity score greater than 0.5. These results should assist the field in moving toward the use of algorithms to assist examiners in casework comparisons.

用于枪支取证的三维(3D)测量系统在法医实验室越来越普遍,这些仪器通常与算法相结合,以协助枪支检验人员进行比较。由于不同类型弹药的枪支特征再现性存在差异,因此需要使用各种品牌的弹药对比较算法进行测试。在这项研究中,使用六种常见的弹药品牌,分别从 10 支个案枪支中发射了 30 发子弹,共计 300 个弹壳。所有弹壳均在 Cadre Forensics TopMatch-GS 3D 桌面系统上扫描,并使用 Cadre 的后端面和撞针孔剪切算法进行比较,共进行了 44,850 次比较。接收器操作特征曲线(ROC)和曲线下面积(AUC)用于量化弹药品牌内和品牌间比较算法的性能。相同弹药品牌比较(AUC = 0.964)在统计学上明显优于不同弹药品牌比较(AUC = 0.944)(p = 0.0075)。总体而言,结果普遍表明,当比较中的弹药相同时,枪支特征的再现性更高,但是,无论弹药品牌如何,Cadre 算法在相同来源和不同来源比较之间都表现出极佳的总体区分度(AUC = 0.946)。此外,还对得分阈值进行了评估,以便于从业人员解释算法结果的含义,68.6% 的同源比较结果的相似性得分大于 0.5。这些结果应有助于该领域逐步使用算法来协助检验人员进行案件工作比较。
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引用次数: 0
How specific is the specificity rule in duty to warn or protect jurisprudence following the Pennsylvania Supreme Court's Maas decision? 宾州最高法院Maas案判决后,警告或保护义务的专一性规则有多具体?
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-11 DOI: 10.1111/1556-4029.15664
Allison Radley DO, Alan R. Felthous MD

Of the various rules establishing a mental health clinician's legal duty to take precautions to protect their patient from harming others, the most common is the specificity rule that limits the protective duty to warn reasonably identifiable victims. The specificity rule is important wherein the main or only specified protective measure is warning the victim. In the last quarter century, Pennsylvania adopted the specificity rule from its Supreme Court Emerich decision. In its recent Maas decision, the Pennsylvania Supreme Court expanded the duty to apply to potential victims who are unnamed and unidentifiable except for living on the same floor as the patient of a multiunit building. Victims constituted a group referenced by the patient as a “neighbor,” but from the patient's threats both narrower “next door neighbor” and broader “anyone.” We place this judicial expansion of the duty to warn within the context of professional ethics guidelines and state Tarasoff statutes that pertain to psychiatrists. The potential adverse consequences of this vague expansion of the specificity rule for clinicians, psychiatric patients, and unconnected citizens of Pennsylvania and for other jurisdictions in which courts could misguidedly follow this expansionist example are discussed, along with potential solutions.

在确立心理健康临床医生采取预防措施保护病人不伤害他人的法律义务的各种规则中,最常见的是特异性规则,它限制了警告合理可识别的受害者的保护义务。特异性规则很重要,其中主要或唯一指定的保护措施是警告受害者。在过去的四分之一世纪中,宾夕法尼亚州采用了最高法院埃默里奇判决中的特异性规则。在最近的马斯案判决中,宾夕法尼亚州最高法院扩大了这一义务,将其适用于那些姓名不详、身份不明的潜在受害者,除非他们与多单元楼的病人住在同一层。受害者组成了一个被病人称为“邻居”的群体,但从病人的威胁中,有狭义的“隔壁邻居”和广义的“任何人”。我们将这种警告义务的司法扩展置于与精神科医生有关的职业道德准则和塔拉索夫州法规的背景下。本文讨论了特异性规则的模糊扩展对临床医生、精神病患者、宾夕法尼亚州和其他司法管辖区的非相关公民的潜在不利后果,这些司法管辖区的法院可能被误导地遵循这种扩张主义的例子,并提出了潜在的解决方案。
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引用次数: 0
Fishing for the missing: The application of recreational fish finders for underwater body detection in shallow waters 寻人捕鱼:休闲寻鱼器在浅水区水下尸体探测中的应用。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-11 DOI: 10.1111/1556-4029.15685
Britny A. Martlin MSc, Lynne S. Bell PhD

Early detection of submerged bodies is essential to increase the possibility of recovery. Different water bodies present different challenges, particularly rivers and the ocean, where chances of detection are vastly reduced. Modern recreational fish finders incorporate multiple sonar technologies, including Sidescan sonar, at high-frequency resolutions, similar to commercial units. Recreational units are widely available and usually hull-mounted, allowing them to be utilized on almost any vessel in shallow and difficult to navigate environments. Recreational fish finders are currently an untapped resource which may assist search teams with the early detection and recovery of human remains submerged in shallow water (<20 m). This research investigated the efficacy of a modern recreational fish finder attached to a kayak to detect human proxies and living human volunteers submerged at shallow depths in (1) two indoor freshwater environments and (2) two outdoor environments (a freshwater lake and a nearshore coastal environment). Results demonstrated that recreational fish finders can detect human bodies submerged in both fresh and saltwater contexts at shallow depths within the water column and on the water bottom. Recreational units equipped with Sidescan sonar (800 kHz) provided the necessary resolution for underwater body detection at shallow depths. These sophisticated sensors are currently used by recreational boaters and anglers, and offer the opportunity to increase the eyes in the water not just by search and recovery teams, but by the public itself.

尽早发现被淹没的尸体对于增加恢复的可能性至关重要。不同的水体面临不同的挑战,特别是河流和海洋,在那里被发现的机会大大降低。现代休闲寻鱼器采用多种声纳技术,包括侧扫描声纳,在高频分辨率,类似于商业单位。娱乐单元广泛使用,通常安装在船体上,允许它们在几乎任何船只上使用,在浅水和难以导航的环境中。游憩式寻鱼器是目前尚未开发的资源,可协助搜救队及早发现和打捞被淹没在浅水中的遗体(
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引用次数: 0
Preliminary validation of Amped FIVE software for subject height estimation ampedfive软件用于受试者高度估计的初步验证。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-10 DOI: 10.1111/1556-4029.15674
Reem Ibrahim MSc, Eugene Liscio PEng

Single view metrology poses a persistent challenge in extracting accurate quantitative information from individual images or video frames within the realm of forensic video analysis. Methods such as reverse projection, projective geometry, and photogrammetry have been used in the past with success but require validation and understanding of the limitations of each method. This study aims to conduct a preliminary validation of the subject height estimation feature in Amped FIVE software, which relies on the principles of single view metrology. A group of 14 individuals assumed an upright posture at distances of 2.4 m, 5.4 m, and 10 m away from two security cameras with different resolutions 4k (3840 × 2160) and HD (1920 × 1080). Prior to recording, participants’ heights were measured but were not provided to the researcher in this study until after the analysis was completed. A height scale with clearly marked black and white graduations was used as a control. Height estimations were subsequently obtained using the Measure 3D tool in Amped FIVE software. On average, the overall error was found to be approximately ± 1.3 cm with a standard deviation of 0.9 cm. This study shows that Amped FIVE can provide accurate height estimates in a controlled environment. Future work should be done to test more difficult scenarios in less-than-ideal conditions.

单视图计量提出了一个持续的挑战,从个别图像或视频帧提取准确的定量信息在法医视频分析领域。反投影、射影几何和摄影测量等方法在过去已被成功使用,但需要验证和了解每种方法的局限性。本研究旨在对基于单视图测量原理的ampedfive软件中的被测物高度估计特性进行初步验证。一组14人分别站在2.4米、5.4米和10米的距离处,分别站在两个分辨率分别为4k (3840 × 2160)和高清(1920 × 1080)的摄像头前。在记录之前,测量了参与者的身高,但直到分析完成后才提供给研究人员。使用带有清晰黑白刻度的高度刻度作为对照。随后使用ampedfive软件中的Measure 3D工具获得高度估计。平均而言,总体误差约为±1.3 cm,标准差为0.9 cm。这项研究表明,在受控环境下,ampedfive可以提供准确的高度估计。未来的工作应该在不太理想的条件下测试更困难的场景。
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引用次数: 0
Cross entropy and log likelihood ratio cost as performance measures for multi-conclusion categorical outcomes scales 交叉熵和对数似然比成本作为多结论分类结果量表的性能度量。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-10 DOI: 10.1111/1556-4029.15686
Eric M. Warren PhD, John C. Handley PhD, H. David Sheets PhD

The inconclusive category in forensics reporting is the appropriate response in many cases, but it poses challenges in estimating an “error rate”. We discuss the use of a class of information-theoretic measures related to cross entropy as an alternative set of metrics that allows for performance evaluation of results presented using multi-category reporting scales. This paper shows how this class of performance metrics, and in particular the log likelihood ratio cost, which is already in use with likelihood ratio forensic reporting methods and in machine learning communities, can be readily adapted for use with the widely used multiple category conclusions scales. Bayesian credible intervals on these metrics can be estimated using numerical methods. The application of these metrics to published test results is shown. It is demonstrated, using these test results, that reducing the number of categories used in a proficiency test from five or six to three increases the cross entropy, indicating that the higher number of categories was justified, as it they increased the level of agreement with ground truth.

法医报告中的不确定类别在许多情况下是适当的反应,但它在估计“错误率”方面提出了挑战。我们讨论了与交叉熵相关的一类信息论度量的使用,作为一组替代度量,允许使用多类别报告量表对结果进行性能评估。本文展示了这类性能指标,特别是对数似然比成本,它已经在似然比取证报告方法和机器学习社区中使用,可以很容易地适应于广泛使用的多类别结论量表。这些指标上的贝叶斯可信区间可用数值方法估计。展示了这些度量对已发布的测试结果的应用。使用这些测试结果证明,将熟练程度测试中使用的类别数量从五个或六个减少到三个会增加交叉熵,这表明类别数量越多是合理的,因为它们增加了与基本真理的一致程度。
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引用次数: 0
Twenty-eight days later: The recovery of DNA from human remains submerged in aggressive household chemicals 28天后:从浸泡在腐蚀性家用化学品中的人类遗体中提取DNA。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-10 DOI: 10.1111/1556-4029.15682
Jennifer Snedeker BS, Rachel Houston PhD, Sheree Hughes PhD

Aggressive chemicals intended for cleaning pools or unclogging drains contain high concentrations of dangerous compounds, leading to their nefarious use in dissolving human remains in some criminal cases. The use of these readily accessible household cleaners to destroy human remains and hide evidence of a crime presents a considerable challenge for human identification. However, research on the success of recovering DNA from such remains is limited. Therefore, we investigated the effects of submerging partial human remains (including whole heads, forearms, and hands) in five different household products: bleach, Rid-X® septic treatment, lye drain opener, sulfuric acid drain opener, and muriatic acid (hydrochloric acid) pool cleaner. We evaluated the impact of each chemical, focusing on visual changes, DNA recovery, and the potential for successful human identification through traditional STR or mitochondrial DNA analyses. Exposure to all chemicals altered the appearance of the remains, but DNA recovery was still possible across various time periods, up to 28 days. Human remains exposed to bleach, Rid-X®, and lye produced full STR profiles after 4 weeks. Sulfuric acid shortened this time to 3 weeks, while hydrochloric acid, the most damaging chemical, limited full STR profile recovery to just the first 3 days of exposure. This study demonstrates that although differences in the rate of damage occur depending on the amount of tissue introduced, volume of chemical used, and the specific chemical of choice, DNA-based human identification of remains treated with everyday household cleaners is likely, particularly if bone fragments are recovered.

用于清洁水池或疏通下水道的腐蚀性化学品含有高浓度的危险化合物,导致它们在一些刑事案件中被邪恶地用于溶解人体遗骸。使用这些随手可得的家用清洁剂来销毁人类遗骸和隐藏犯罪证据,对人类身份鉴定提出了相当大的挑战。然而,从这些遗骸中成功提取DNA的研究是有限的。因此,我们研究了将部分人体遗骸(包括整个头部、前臂和手)浸泡在五种不同的家用产品中的效果:漂白剂、Rid-X®化脓剂、碱液排水器、硫酸排水器和盐酸(盐酸)泳池清洁剂。我们评估了每种化学物质的影响,重点关注视觉变化、DNA恢复以及通过传统STR或线粒体DNA分析成功进行人类鉴定的潜力。暴露在所有化学物质中都会改变遗体的外观,但DNA在不同的时间段内仍然可以恢复,最长可达28天。人类遗骸暴露于漂白剂,Rid-X®和碱液4周后产生完整的STR谱。硫酸将这一时间缩短至3周,而最具破坏性的化学物质盐酸将整个STR剖面的恢复限制在暴露后的前3天。这项研究表明,尽管损伤率的不同取决于引入的组织数量、使用的化学物质的体积和所选择的特定化学物质,但用日常家用清洁剂处理过的遗骸的dna人类鉴定是可能的,特别是如果骨头碎片被恢复的话。
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引用次数: 0
Prevalence of new psychoactive substances and drugs of abuse in the hair of individuals diagnosed with substance use disorder: Polydrug and emerging pattern of consumption 新精神活性物质和药物滥用在被诊断为物质使用障碍的个体的头发中的流行:多种药物和新出现的消费模式。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-10 DOI: 10.1111/1556-4029.15683
Arianna Giorgetti MD, PhD, Susan Mohamed BSc, Filippo Pirani MD, PhD, Rossella Barone PhD, Marialuisa Grech MD, Paolo Fais MD, PhD, Jennifer Paola Pascali PhD, Guido Pelletti MD, PhD

People diagnosed with substance use disorder (SUD) might represent a high-risk subpopulation for New Psychoactive Drugs (NPS) consumption, and hair analysis offers a unique perspective to assess drug prevalence in this population. The present study aims to assess the prevalence of NPS and their co-consumption with traditional drugs of abuse (DoA) in individuals diagnosed with SUD. Hair samples from patients under care at the addiction treatment service of Bologna, Italy, for a diagnosed SUD, were collected during 2023 and analyzed by ultra-high-performance liquid chromatography-mass spectrometry (UHPLC–MS/MS), using a previously validated method. Among the 88 patients included, 95.5% tested positive for at least one substance, of which 88.1% for traditional DoA only, and 11.9% for NPS in addition to DoA. Among the positive samples, patients were found positive for more than two drugs in 67.9% of cases. The combination of DoA and NPS was more frequent in the younger age group (<21–30 years old, compared to 31–70, p = 0.025). Ketamine was detected in 8.0% of all samples, with mean hair levels 49.68 pg/mg (ranging 8.55–81.90 pg/mg) and was frequently accompanied by cocaine (85.7% of cases). Fentanyl was detected in 3.4% of all samples, while, among NPS, buphedrone was the only one detected. Our retrospective study highlights that the consumption of NPS is relatively low compared to other vulnerable or high-risk populations. However, the prevalence of polydrug consumption and the high rate of ketamine–cocaine combination warrant careful monitoring even in this population.

被诊断为物质使用障碍(SUD)的人可能是新型精神活性药物(NPS)消费的高风险亚人群,头发分析为评估这一人群的药物流行情况提供了一个独特的视角。本研究旨在评估NPS在诊断为SUD的个体中的患病率及其与传统药物滥用(DoA)的共同消费。研究人员于2023年在意大利博洛尼亚的成瘾治疗服务中心收集了诊断为SUD的患者的头发样本,并使用先前验证的方法,通过超高效液相色谱-质谱(UHPLC-MS/MS)进行了分析。在纳入的88例患者中,95.5%的患者至少有一种物质检测呈阳性,其中88.1%仅为传统DoA, 11.9%为NPS + DoA。阳性样本中,两种以上药物阳性的占67.9%。DoA和NPS合并在年轻年龄组中更为常见(
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引用次数: 0
Venous aneurysm leading to fatal pulmonary thromboembolism with a history of a remote stab wound of the extremity 静脉动脉瘤导致致命的肺血栓栓塞与历史远端刺伤的四肢。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-12-06 DOI: 10.1111/1556-4029.15687
Emily Helmrich DO, Erin Risotto-Urbanowicz MD, Pierce Massie MD, Ross Clark MD

Venous aneurysms are rare, and their incidence is unknown. External iliac vein aneurysms are even more rare with only 50 case reports published from 1950 to 2018. We present a case of an individual who died suddenly from a pulmonary thromboembolic event due to an external iliac vein aneurysm formed by a remote penetrating injury. A 32-year-old male was in Immigration and Customs Enforcement (ICE) custody when he died suddenly. It was discovered during his autopsy that he had an occlusive pulmonary thromboembolism (PE) within the left main pulmonary artery and distal branches of the right pulmonary artery. On additional investigation and postmortem computed tomography, a large saccular aneurysm arising from the external iliac vein was discovered. This aneurysm contained clotted blood, and was determined to be the cause of his PE and subsequent death. Although rarely a source for a fatal PE, venous aneurysms should be considered as a possible source for thromboembolism; their presence may alter the manner of death, given their underlying etiology. This is especially true for young adults with a remote history of trauma near a major venous tributary, as traumatic arteriovenous fistula is a common cause of secondary venous aneurysm. For this case, the manner of death was classified as homicide.

静脉动脉瘤是罕见的,其发病率是未知的。髂外静脉动脉瘤更为罕见,从1950年到2018年仅发表了50例病例报告。我们提出了一个病例的个人谁突然死于肺血栓栓塞事件由于远端穿透性损伤形成的髂外静脉动脉瘤。一名32岁的男性在移民和海关执法局(ICE)拘留期间突然死亡。在他的尸检中发现他在左肺动脉主干和右肺动脉远端分支有闭塞性肺血栓栓塞(PE)。在进一步的调查和死后的计算机断层扫描中,发现了一个起源于髂外静脉的大囊状动脉瘤。这个动脉瘤含有凝血,并被确定为他肺动脉栓塞和随后死亡的原因。尽管静脉动脉瘤很少是致死性PE的来源,但应将其视为血栓栓塞的可能来源;鉴于其潜在的病因,它们的存在可能会改变死亡的方式。对于在主要静脉支流附近有长期创伤史的年轻人尤其如此,因为外伤性动静脉瘘是继发性静脉动脉瘤的常见原因。在这个案件中,死亡方式被归类为他杀。
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引用次数: 0
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Journal of forensic sciences
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