ABSTRACT
We present the case of a 3.5-year-old boy with sudden anal blood loss at school. Sexual abuse was suspected, and, apart from anal fissures seen on sigmoidoscopy, no other clinical signs of any sort of disorder were present. As no medical explanation for the blood loss could be given, penetrating anal trauma was suggested. During follow-up consultations, there were complaints of occasional blood loss. Platelet aggregation tests and electron microscopy finally helped diagnose a delta-storage pool disease which is a rare haemostatic disorder involving the dense granules of the platelets. Although exclusion of well-known blood diseases through routine laboratory testing is a common practice in children with sudden blood loss, this case illustrates the value of more specialised investigation both from a diagnostic and forensic point of view.
Subject(s)
Anus Diseases/etiology , Gastrointestinal Hemorrhage/etiology , Platelet Storage Pool Deficiency/diagnosis , Child Abuse, Sexual/diagnosis , Child, Preschool , Diagnosis, Differential , Forensic Medicine , Humans , Male , Platelet Storage Pool Deficiency/complicationsABSTRACT
Clinical forensic medicine is a relatively new discipline in Belgium although (sexual) violence has been around for centuries. A brief overview of the Belgian legal system and the way it interacts with forensic medicine is presented, with special emphasis on the investigation of complainants of sexual violence. The epidemiology of sexual violence in Belgium is discussed together with the procedures that were developed by the government to standardise the medical examination of sexual assault victims.
Subject(s)
Crime Victims , Forensic Medicine , Rape/legislation & jurisprudence , Belgium , Forensic Medicine/methods , Health Services Accessibility , HumansABSTRACT
Desmoplastic infantile ganglioglioma is a rare intracranial tumor of early childhood with a usually excellent prognosis despite malignant features both radiologically and histologically. We present the case of a desmoplastic infantile ganglioglioma with histologically highly anaplastic features and both intracerebral and pial metastases. After partial resection the tumor was rapidly progressive and new metastases appeared. A combination of vincristine and carboplatinum was used according to the Low Grade Glioma Protocol of the International Society of Pediatric Oncology, with a temporary good response. When histologically characterized by highly anaplastic features, it seems the biologic behavior of this tumor remains uncertain. The aggressive behavior and the responsiveness to chemotherapy in this case may challenge the belief in the benign nature of these rare tumors.
Subject(s)
Brain Neoplasms/pathology , Ganglioglioma/secondary , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor/analysis , Brain/pathology , Brain Neoplasms/chemistry , Brain Neoplasms/therapy , Carboplatin/administration & dosage , Child, Preschool , Desmin , Fatal Outcome , Female , Ganglioglioma/chemistry , Ganglioglioma/therapy , Humans , Immunohistochemistry , Magnetic Resonance Imaging , Neoplasm Proteins/analysis , Vincristine/administration & dosageABSTRACT
Over 1 million dog bites occur every year in the USA, however, fatal dog bites are rare and mostly affect children under 4 years of age and old people. Usually pet dogs are involved and only recently has public awareness of this health problem increased. As an example of a forensic approach we present the case of a 6-year-old girl who was killed by the three pet Rottweilers of her father. The present report includes the investigation of the death scene, the autopsy findings and the results of the examination of the dogs. Dog bite wounds in this case typically were limited to the head and neck regions and classic features of these wounds have been described in various studies. We emphasise the particulars of canine dental features, discuss the resulting bite wounds and, reviewing the literature, try to come up with a strategy for prevention.
