Soudni Lekarstvi最新文献

Vertebral artery aneurysm rupture is a rare cause of sudden death. The presented case was 31-year-old woman who was found dead in her bedroom. Family members stated that she had history of one year duration childhood epilepsy treatment. Autopsy investigation revealed 5 mm in diameter aneurysm, ruptured in 1 mm area, localized on the trunk of the right vertebral artery. We described an autopsy case of sudden unexpected death due to ruptured vertebral artery aneurysm.

Aortic arch blunt injury has highly lethal nature. Because the physical examination findings are subtle, immediate medical evaluation is very important. The case was a 72-year-old woman. Massive haemorrhage in the left haemotorax, contusion area in the left lung and a traumatic transection of the distal aortic arch was observed during autopsy. We described intersting autopsy case of aortic arch blunt injury.

Tracheo-brachiocephalic artery fistulas were rarely reported lesions often described in cases with tracheostomy procedures. Reported case was 26 year-old male drainage worker, trapped under the stony soil while excavating drainage canal. Rescue operation was performed, but he was reached dead. Provincial prosecutor mandated autopsy after crime scene investigation. Autopsy examination revealed traumatically formed tracheo-brachiocephalic fistula. We aimed to report an intersting case of traumatic tracheo-brachiocephalic artery fistula identified in forensic autopsy.

Unlabelled: It is a well-known fact that after drinking the same amount of alcohol, women show more signs of the effects of alcohol than men of the same weight. It seems that the main factors responsible for sex differences in alcohol metabolism and influence are the relatively lower amount of body water related to body fat in women than men and lower gastric ADH activity in women, both of which enable women to reach higher BAC after drinking equivalent amounts of alcohol with men. On the other hand, first-pass metabolism of alcohol during passing through the liver is more rapid in women, probably due to bigger liver mass in women than in men. It is proven that alcohol and sex hormones have bilateral influence on each other. Women with more rapid alcohol elimination ability show higher levels of sex hormones in blood than the rest. It seems that the specific body constitution of the female organism as well as the unique combination of their sex hormones is responsible for the gender differences in alcohol influence.

Keywords: alcohol metabolism - gender differences - gastric ADH - blood alcohol concentration.

Keywords: self-inflicted wounds - forensic - signs.

Unlabelled: Arrhythmogenic right ventricular dysplasia (ARVD) is both a myocardial disease that predominantly affects the right ventricle (RV) and one of the major causes of sudden death in the young and athletes. A 28-year-old man with no signicant medical history, applied to an emergency department with feeling very ill. After his initial examinations, electrocardiography (ECG) showed ventricular extra systoles and he was recommended for admission to a cardiology polyclinic. The next day, his condition worsened and he was dead on arrival at the hospital. A histological examination of heart samples, which were obtained from the RV and LV, revealed the massive replacement of myocardium by fibrous and mature adipose tissue in the RV. In this case, there were no symptoms, family and medical history and its clinical presentation was as an unexpected sudden death.

Keywords: Arrhythmogenic right ventricular dysplasia, sudden cardiac death, autopsy.

Unlabelled: External mechanical resuscitation systems were developed for continuous and effective chest compression with the goal to increase the probability of spontaneous blood circulation renew. We describe results of four autopsy cases, where the external mechanical resuscitation by system Lucas (n=3) and AutoPulse (n=1) was performed prior to death. In all the cases were found traumatic changes which are commonly described in various studies such as skin abrasions on the chest, multiple rib fractures, fracture of the sternum and hematoma in the mediastinum or pericardium. In addition to these usual traumatic changes accompanying mechanical cardiopulmonary resuscitation we have observed injuries of intrathoracic organs, mainly the contusions of the heart and contusions and laceration of the lungs. In addition to these changes were in one case, associated with prolonged AutoPulse resuscitation, found ruptures of intima of the right common carotid artery. These injuries, with few exceptions, are not commonly described even over much wider number of examined persons. Injuries of the abdominal organs in connection with mechanical resuscitation, as described in a few case reports, were not present. However in one case there was found contusion of myocardium due to the external resuscitation by the Lucas system with clinical manifestation of sudden coronary incident even though the cause of death was massive thrombotic embolism to pulmonary arteries. All reported cases were similar in the relatively long-lasting mechanic cardiopulmonary resuscitation and prolonged time of dying of the patients.

Keywords: cardiopulmonary resuscitation - Lucas - AutoPulse - intrathoracic injury.

Unlabelled: Reported case was 46-year-old woman found dead at the forest park rest area. Autopsy examination revealed grossly but normal in appearance heart weighed 400 gr. The orifice of right coronary artery round in shape was situated in the ascending aorta; 17 mm above the sinotubular junction, there was a high take-off coronary artery with ectopic localization. Dissection of the artery confirmed that the proximal segment of the right coronary artery passed between the aorta and pulmonary artery, with acute, oblique down-ward angulation. We aimed to present the rare coronary anomaly and discuss the case from medico legal aspect.

Keywords: Sudden cardiac death - coronary artery - high take-off - ectopic - autopsy.

Firearm-related injuries are a major problem worldwide, in forensic medicine practice. and unusual presentation of bullet trajectory can create surgical or medico-legal diagnostic problems. A 23-year-old man suffered two gunshot wounds, was taken to emergency department immediately after the incident. Physical examination revealed two entrance gunshot wounds on the left lumbar region under the lower margin of left scapulae and right gluteal region. An exit wound was defined on the lateral side of the right gluteal region which was located 5 cm distance of entrance wound. Radiological investigation showed a bullet in the tongue without any life threatening impairment. A thoracic CT scan and abdominal USG were normal. Following the initial examinations he was hospitalized and the bullet removed from the tongue by a simple surgical operation. An interesting case of gunshot injury where the passage route of bullet extending along from upper posterior part of the left lumbar region to the tongue without vital organ injury or serious disability has been reported.

Craniocerebral penetrating non-missile injuries caused by metallic foreign bodies are uncommon events. Healthy 10 year-old boy applied to the hospital emergency service with his parents. Family members stated that the scissors have been stalled his head accidentally by his sister when they had played together. During physical examination the scissors located on left parietal region of the head was examined. There was no loss of consciousness and oriented with normal vital signs. Radiological investigation demonstrated a hyper dense foreign body (scissors) penetrating cranial cavity and ended before reaching posterior region of the left parietal lobe. To our knowledge, the presented was rare case of intracranial penetrating scissor, which was not removed until, injured, reached the hospital. Our goal was to discuss the rare case of penetrating non-missile foreign body cranial injury from medico legal aspect.