Sudden Death Due to Undiagnosed Ludwig’s Angina: An Autopsy Case Report / 대한법의학회지

Ludwig’s angina is a rapidly progressive and gangrenous cellulitis in the submandibular, sublingual spaces, and neck. It is characterized by an elevated tongue and laryngeal edema, resulting in airway compromise and, rarely, in sudden death. The most common cause is an odontogenic infection of a molar tooth. Infection can spread to the superior mediastinum and buccal area through anatomical structures. Herein, we report the sudden death of a 45-year-old male who was not diagnosed with Ludwig’s angina. He died in the emergency room 20 minutes after loss of consciousness. Intubation was impossible owing to severe laryngeal edema. The C-reactive protein level was 33.81 mg/dL. On autopsy, a diffuse light green abscess of the submandibular space was detected, along with severe edema of the epiglottis, aryepiglottic fold, and vocal cords. Subsequently, we confirmed that the airway obstruction was caused by Ludwig’s angina based on a literature review. In conclusion, this report emphasizes the need to identify the infection source and perform a detailed dissection according to the anatomical structure in the autopsy procedure for Ludwig’s angina.

Congenital Complete Left-Sided Absence of the Pericardium Incidentally Identified in the Autopsy: A Case Report / 대한법의학회지

Congenital absence of the pericardium, also known as pericardial agenesis, is an extremely rare anomaly. Although most cases are asymptomatic, some experience chest pain, dyspnea, dizziness, and syncope. A few sudden death cases have been reported. We report a case of congenital complete left-sided absence of the pericardium that is not related to the cause of death. In the autopsy of a skinny 45-year-old deceased man, there was no left pericardium, and the heart had direct contact with the left lung. Inflammation and adhesion around the heart, torsion of great vessels, structure abnormality of the heart, and histologic lesion of the myocardium were absent. Due to the chemical analysis result and morphology, we suspected that the cause of death was related to starvation. The congenital absence of the pericardium is usually accompanied by myocardial infarction, aortic dissection, and variable congenital anomalies in the heart and other organs. Additionally, both complete and partial defects can cause myocardial infarction. Therefore, we suggest that precise gross examination should be performed to determine the ischemic lesions in the heart and other anomalies if congenital absence of the pericardium is noted in the autopsy.

A Literature Review on the Growth Rate Experiment for Necrophagous Fly Species Commonly Observed in Korea and Consideration for Minimum Postmortem Interval Estimation / 대한법의학회지

Estimation of the minimum post-mortem interval (PMI-min) by means of forensic entomology is mainly based on the results of the growth rate studies on necrophagous flies. However, results of these studies are difficult to use because these studies have only been undertaken for a select few necrophagous flies, and experimental methods and results processing have not been standardized. In this review, we have summarized the current state of growth rate studies on necrophagous fly species that are frequently found in human cadavers. Criteria have been suggested in order to select reliable data, and the accumulated degree hours and base temperatures to be used in the calculation of PMI-min for each species have been tabulated.