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1.
Article in Korean | WPRIM | ID: wpr-926667

ABSTRACT

Esophageal foreign body impaction may be fatal secondary to occlusion of the glottis or external compression of the membranous portion of the trachea. A 14-year-old adolescent female was admitted to the emergency department for evaluation of sudden dyspnea and cyanosis after she swallowed a food bolus (a part of bachelor radish kimchi) without chewing. Unfortunately, the patient died despite cardiopulmonary resuscitation. Autopsy findings showed an ovoid, firm foreign body (3.5×2.5×2 cm) impacted in the proximal esophagus, with focal narrowing of the tracheal lumen secondary to external compression by esophageal foreign body impaction. Death was attributed to choking caused by an esophageal foreign body.

2.
Article in Korean | WPRIM | ID: wpr-917815

ABSTRACT

Histiocytoid cardiomyopathy, an extremely rare heart disease in infants and children, usually occurring in girls under the age of 2 years, is characterized by cardiomegaly, ventricular arrhythmia, and sudden death. In the present study, we report a case of a 2-day-old female neonate who suddenly showed cyanosis and cardiac arrest in the neonatal unit and died without resuscitation. Autopsy revealed multifocal nodular lesions in the left ventricle wall and papillary muscles. Microscopically, these lesions were composed of discohesive round or polygonal cells with eosinophilic cytoplasm and were positive for desmin and negative for CD68. Electron microscopy findings displayed abnormal swollen mitochondria with disorganized cristae, dense granules, and diminished myofibrils in the periphery of the cytoplasm.

3.
Article | WPRIM | ID: wpr-836580

ABSTRACT

Sodium nitrite intoxication is a primary cause of severe methemoglobinemia, which may be fatal. In the past, nitrite-related deaths were rare, but cases of suicide with nitrite have been increasing in number in recent years. We analyzed 14 cases of fatal nitrite intoxication from January 2013 to February 2019. There was a different trend between the cases from the past and those from recent years. The former consisted of older individuals who ingested nitrite accidentally or intentionally, while the latter comprised younger individuals who used nitrite mostly for suicide. Most individuals showed dark purple or dark brown lividity and cherry-pink discoloration of the muscles. Postmortem methemoglobin levels, which were analyzed in 5 cases, were 30%-49%. Most nitrite and nitrate concentrations showed the highest concentration in the stomach contents, and it showed that the nitrite was converted into nitrate in the blood. To conclude, methemoglobin tests using a portable oximeter and quantitative tests of nitrite and nitrate, as well as a thorough investigation of the case and scene may help determine the cause of death.

4.
Article in Korean | WPRIM | ID: wpr-917797

ABSTRACT

Most sharp force fatalities are attributed to homicide or suicide, with only a few accidental cases reported to date. Broken glass accounts for most of these accidental fatalities. We herein report an unusual accidental death caused by a broken glass cup. A 21-year-old woman was found dead on the floor of her studio apartment. The studio was a duplex consisting of one room and a bathroom, with a stepped drawer leading to the second floor. She was lying face down with her legs spread apart in a large pool of blood, surrounded by many pieces of broken glass. There was an oblique cut measuring 9 cm in length in the right sternocleidomastoid region just above the right clavicle. The surface of the cut wound showed irregular edges and the internal jugular vein was severed in the depth of the wound. She appeared to have fallen down the steps onto the ground floor and been fatally injured in the neck by a piece of broken glass.

5.
Article in English | WPRIM | ID: wpr-917791

ABSTRACT

The deceased was found in the basement staircase of a commercial building. He was drunk the night before his death. He went into the building at 00:45 am as per the security camera recording. He was found at 9:10 am in an inverted and jackknife position causing the hyperflexion of his torso and neck. Autopsy findings revealed facial congestion and conjunctival petechiae. No evidence of critical trauma was noted. Therefore, he can be diagnosed with positional asphyxia. He must have lost his body balance and fallen on his back while climbing up the basement staircase for unknown reasons. His lower body was found to be in the jackknife position due to inertia. The drunken state and the accident prevented movement and this position was sustained for an extended period.

6.
Article in English | WPRIM | ID: wpr-759867

ABSTRACT

The deceased was found in the basement staircase of a commercial building. He was drunk the night before his death. He went into the building at 00:45 am as per the security camera recording. He was found at 9:10 am in an inverted and jackknife position causing the hyperflexion of his torso and neck. Autopsy findings revealed facial congestion and conjunctival petechiae. No evidence of critical trauma was noted. Therefore, he can be diagnosed with positional asphyxia. He must have lost his body balance and fallen on his back while climbing up the basement staircase for unknown reasons. His lower body was found to be in the jackknife position due to inertia. The drunken state and the accident prevented movement and this position was sustained for an extended period.


Subject(s)
Accidental Falls , Asphyxia , Autopsy , Estrogens, Conjugated (USP) , Neck , Purpura , Torso
7.
Article in Korean | WPRIM | ID: wpr-740692

ABSTRACT

Most sharp force fatalities are attributed to homicide or suicide, with only a few accidental cases reported to date. Broken glass accounts for most of these accidental fatalities. We herein report an unusual accidental death caused by a broken glass cup. A 21-year-old woman was found dead on the floor of her studio apartment. The studio was a duplex consisting of one room and a bathroom, with a stepped drawer leading to the second floor. She was lying face down with her legs spread apart in a large pool of blood, surrounded by many pieces of broken glass. There was an oblique cut measuring 9 cm in length in the right sternocleidomastoid region just above the right clavicle. The surface of the cut wound showed irregular edges and the internal jugular vein was severed in the depth of the wound. She appeared to have fallen down the steps onto the ground floor and been fatally injured in the neck by a piece of broken glass.


Subject(s)
Clavicle , Deception , Female , Glass , Homicide , Humans , Jugular Veins , Leg , Neck , Neck Injuries , Suicide , Wounds and Injuries , Young Adult
8.
Article in Korean | WPRIM | ID: wpr-917783

ABSTRACT

In Korea, small octopus (Octopus minor) and webfoot octopus (Octopus ocellatus) are food items and fatal laryngeal choking due to ingestion of live octopus is not uncommon. We recently encountered two autopsy cases of accidental choking on small octopus and webfoot octopus. Case 1 involved a 58-year-old fisherman who ingested two live webfoot octopuses in his fishing boat and collapsed. He was immediately taken to the hospital but died. During autopsy, one of the webfoot octopuses was found between his pharynx and esophagus; it was obstructing the epiglottis and upper esophagus. His blood alcohol concentration was 0.140%. Case 2 involved a 55-year-old man who ingested an intact body part of a small octopus and was found dead in his house. He had a history of cerebral infarction and angina pectoris. During autopsy, an intact body part of the small octopus was found to be lodged in the laryngeal inlet.

9.
Article in Korean | WPRIM | ID: wpr-917776

ABSTRACT

Recently, fatal nicotine intoxications with electronic cigarette liquid have increased in Korea, but various kinds of cigarettes and smoking cessation aids may also cause fatal poisoning. We report cases of fatal nicotine intoxications involving causes other than the use of liquid nicotine. A 29-year-old woman (case 1) found dead in a hotel room with about 70 patches (21 mg dose) of nicotine on her body. Blood nicotine levels were 7.68 mg/L (heart) and 3.25 mg/L (femoral). A toxic level of zolpidem was also detected. A 28-year-old Uzbekistan man (case 2) was found dead in his uncle's room with his face covered with chewing tobacco. Blood nicotine levels were 7.3 mg/L (heart) and 4.6 mg/L (femoral). Blood alcohol level was 0.139%. A 55-year-old man (case 3) bit his tongue. As he was taken to the hospital, his wife put tobacco powders in his mouth for hemostasis, and he died of cardiac arrest. Blood nicotine levels were 2.01 mg/L (heart) and 0.96 mg/L (femoral). Nicotine-related deaths can be caused by various types of administration including transdermal and transmucosal routes, and relatively small doses may cause death, so meticulous investigation should be taken when such deaths are suspected.

10.
Article in English | WPRIM | ID: wpr-917775

ABSTRACT

Venipuncture is a routine and relatively safe and painless medical procedure, necessary for accurate diagnosis and treatment. However, given that pain related to medical procedures may have adverse effects for children, could venipuncture cause deaths in infants and children? We analyzed our cases of unexpected death after venipuncture and conducted a literature review on them. A vasovagal response to noxious stimuli may explain such a sudden death immediately after venipuncture, commonly presented as needle phobia, breath-holding spell, and reflex anoxic seizure in the literature, despite the fact that the current medical evidence is not enough to prove their casual relationship. In addition, pain prevention and management during medical procedure is incorporated in clinical guidelines for pediatric patients, because painful medical procedures negatively affect child development. Thus, prevention and management of pain related to medical procedure may be helpful to avoid an adverse vasovagal response to noxious stimuli from occurring.

11.
Article in English | WPRIM | ID: wpr-917768

ABSTRACT

Popliteal venous aneurysms can be a cause of fatal pulmonary thromboembolism. We report a case of a 47-year-old woman who suddenly died of fatal pulmonary thromboembolism. Deep vein thrombosis was not observed, but a venous aneurysm with intraluminal thrombi formation was identified on the left popliteal vein. This case illustrates that venous aneurysms can be presented as fatal pulmonary thromboembolism, and that they should be considered as a rare cause of pulmonary thromboembolism.

12.
Article in Korean | WPRIM | ID: wpr-740683

ABSTRACT

In Korea, small octopus (Octopus minor) and webfoot octopus (Octopus ocellatus) are food items and fatal laryngeal choking due to ingestion of live octopus is not uncommon. We recently encountered two autopsy cases of accidental choking on small octopus and webfoot octopus. Case 1 involved a 58-year-old fisherman who ingested two live webfoot octopuses in his fishing boat and collapsed. He was immediately taken to the hospital but died. During autopsy, one of the webfoot octopuses was found between his pharynx and esophagus; it was obstructing the epiglottis and upper esophagus. His blood alcohol concentration was 0.140%. Case 2 involved a 55-year-old man who ingested an intact body part of a small octopus and was found dead in his house. He had a history of cerebral infarction and angina pectoris. During autopsy, an intact body part of the small octopus was found to be lodged in the laryngeal inlet.


Subject(s)
Airway Obstruction , Angina Pectoris , Autopsy , Bays , Blood Alcohol Content , Cerebral Infarction , Eating , Epiglottis , Esophagus , Humans , Korea , Larynx , Middle Aged , Octopodiformes , Pharynx , Ships
13.
Article in English | WPRIM | ID: wpr-740678

ABSTRACT

Popliteal venous aneurysms can be a cause of fatal pulmonary thromboembolism. We report a case of a 47-year-old woman who suddenly died of fatal pulmonary thromboembolism. Deep vein thrombosis was not observed, but a venous aneurysm with intraluminal thrombi formation was identified on the left popliteal vein. This case illustrates that venous aneurysms can be presented as fatal pulmonary thromboembolism, and that they should be considered as a rare cause of pulmonary thromboembolism.


Subject(s)
Aneurysm , Female , Forensic Pathology , Humans , Middle Aged , Popliteal Vein , Pulmonary Embolism , Venous Thrombosis
14.
Article in Korean | WPRIM | ID: wpr-740671

ABSTRACT

Recently, fatal nicotine intoxications with electronic cigarette liquid have increased in Korea, but various kinds of cigarettes and smoking cessation aids may also cause fatal poisoning. We report cases of fatal nicotine intoxications involving causes other than the use of liquid nicotine. A 29-year-old woman (case 1) found dead in a hotel room with about 70 patches (21 mg dose) of nicotine on her body. Blood nicotine levels were 7.68 mg/L (heart) and 3.25 mg/L (femoral). A toxic level of zolpidem was also detected. A 28-year-old Uzbekistan man (case 2) was found dead in his uncle's room with his face covered with chewing tobacco. Blood nicotine levels were 7.3 mg/L (heart) and 4.6 mg/L (femoral). Blood alcohol level was 0.139%. A 55-year-old man (case 3) bit his tongue. As he was taken to the hospital, his wife put tobacco powders in his mouth for hemostasis, and he died of cardiac arrest. Blood nicotine levels were 2.01 mg/L (heart) and 0.96 mg/L (femoral). Nicotine-related deaths can be caused by various types of administration including transdermal and transmucosal routes, and relatively small doses may cause death, so meticulous investigation should be taken when such deaths are suspected.


Subject(s)
Adult , Blood Alcohol Content , Electronic Nicotine Delivery Systems , Female , Heart Arrest , Hemostasis , Humans , Korea , Middle Aged , Mouth , Nicotine , Poisoning , Powders , Smoking Cessation , Spouses , Tobacco , Tobacco Products , Tobacco Use Cessation Devices , Tobacco, Smokeless , Tongue , Uzbekistan
15.
Article in English | WPRIM | ID: wpr-740670

ABSTRACT

Venipuncture is a routine and relatively safe and painless medical procedure, necessary for accurate diagnosis and treatment. However, given that pain related to medical procedures may have adverse effects for children, could venipuncture cause deaths in infants and children? We analyzed our cases of unexpected death after venipuncture and conducted a literature review on them. A vasovagal response to noxious stimuli may explain such a sudden death immediately after venipuncture, commonly presented as needle phobia, breath-holding spell, and reflex anoxic seizure in the literature, despite the fact that the current medical evidence is not enough to prove their casual relationship. In addition, pain prevention and management during medical procedure is incorporated in clinical guidelines for pediatric patients, because painful medical procedures negatively affect child development. Thus, prevention and management of pain related to medical procedure may be helpful to avoid an adverse vasovagal response to noxious stimuli from occurring.


Subject(s)
Autopsy , Child , Child Development , Death, Sudden , Diagnosis , Forensic Pathology , Humans , Infant , Infant Death , Needles , Phlebotomy , Phobic Disorders , Reflex , Seizures
16.
Article in Korean | WPRIM | ID: wpr-107261

ABSTRACT

Nitrous oxide is medically used as an anesthetic gas and as an additive in whipped cream production. Few cases of death from nitrous oxide intoxication have been reported in Korea. However, fatalities due to inhalation of pure nitrous oxide in an amount enough to cause death have been recently increasing. We report two cases of death related to nitrous oxide abuse with a review of literature focusing on the fact that nitrous oxide abuse can be considered as a possible cause of death if appliances with nitrous oxide contents were found during the investigation, and the autopsy and toxicological findings cannot be attributed to nitrous oxide intoxication.


Subject(s)
Autopsy , Cause of Death , Inhalant Abuse , Inhalation , Korea , Nitrous Oxide , Toxicology
17.
Article in English | WPRIM | ID: wpr-67293

ABSTRACT

Acute fatty liver of pregnancy (AFLP) is one of the sudden unexpected causes in pregnancy and maternal deaths. It has been considered as a potential fatal disease in pregnancy, but the postmortem findings of AFLP is not well known. Because an unexpected maternal death may lead to a legal dispute, forensic pathologists should be aware of clinical presentations and postmortem findings of AFLP. Therefore, we presented our case and reviewed with literatures.


Subject(s)
Autopsy , Dissent and Disputes , Fatty Liver , Forensic Pathology , Maternal Death , Pregnancy
18.
Article in Korean | WPRIM | ID: wpr-67292

ABSTRACT

Investigating neonatal deaths in the toilets is challenging for forensic pathologists. During the postmortem examination, they should evaluate whether the baby was alive or a stillbirth and determine any causes of death, such as prenatal cause, infection, anatomical abnormalities, birth or other blunt force injury, drowning, and asphyxia. We retrieved two cases of neonatal deaths in the toilets and reviewed their autopsy findings and circumstances. However, findings from the postmortem examination were insignificant. Their lung examinations revealed non-expanded alveoli, and hydrostatic tests were negative. However, the cases cannot be confirmed as stillbirths because of the possibility that they might be alive for a short period of time after birth and then exposed into the water in the toilet or to accidental or non-accidental asphyxia or that they might have died because of neglect. These cases illustrate that the death scene and the associated circumstances should be meticulously and carefully investigated.


Subject(s)
Asphyxia , Autopsy , Cause of Death , Drowning , Forensic Pathology , Humans , Infant, Newborn , Lung , Parturition , Perinatal Death , Stillbirth , Water
19.
Article in Korean | WPRIM | ID: wpr-211157

ABSTRACT

Drowned bodies with bound wrists are occasionally observed in forensic practice. Suicidal victims may bind their hands or feet with a rope to ensure success of the suicide attempt, but the possibility of homicidal drowning cannot be excluded. We report on two autopsy cases of drowning with bound wrists. A 51-year-old man (case 1) was found in the bathroom beside the bathtub, with his head under the water in the bathtub. His wrists were tied with a green bath towel. An 83-year-old man (case 2) was found dead in a reservoir. His wrists were loosely bound with blue nylon traps on the back, and both ankles were loosely tied with socks, with a simple knot on the left ankle. At autopsy, the lungs were hyperinflated, and foamy fluid was exuded from the bronchi in both cases.


Subject(s)
Aged, 80 and over , Ankle , Autopsy , Baths , Bronchi , Drowning , Foot , Hand , Head , Humans , Lung , Middle Aged , Nylons , Suicide , Water , Wrist
20.
Article in Korean | WPRIM | ID: wpr-217845

ABSTRACT

We report the case of a 66-year-old man who died of fatal delayed hemothorax after blunt trauma to the chest. When the deceased was transferred to the hospital, his vital signs were stable; hence, medical attention was focused only on the fracture on right ankle. Three days after the orthopedic surgery, he became unsettled with symptoms similar to delirium and exhibited unstable vital signs; he then suddenly died. On autopsy, a beveled fracture was identified on the posterior aspect of the left second rib with hemothorax. It was because of a rupture in the intercostal artery at the fracture site that a simple fracture in a rib, following a blunt chest trauma can be a potentially life-threatening condition. We suggest that a meticulous examination should be performed at the rib fracture sites when a blunt trauma to the chest is suspected even when there are no internal organ injuries identified except hemothorax.


Subject(s)
Aged , Ankle , Arteries , Autopsy , Delirium , Hemothorax , Humans , Orthopedics , Rib Fractures , Ribs , Rupture , Thorax , Vital Signs
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