Boerhaave syndrome resulting from homicidal blunt trauma.

Boerhaave syndrome is an uncommon condition with high rate of mortality that is higher than 90%. The syndrome has classically been associated with sudden severe chest pain after severe emesis or retching. However, traumatic esophageal rupture secondary to blunt injury has been occasionally reported in the literature, usually from unintentional injury. We report the first case of Boerhaave syndrome resulting from homicidally inflicted blunt trauma to the abdomen, which is a rare finding that can be easily missed during an autopsy.

Determining postmortem interval using glycoproteinous adhesion deposits by Balanus improvisus on human skeletal and dental remains.

An anthropological analysis was conducted on skeletal and dental remains brought to the Galveston County Medical Examiner's office. The skeletal remains were dry, fragmented, and absent of typical fluvial characteristics. During microscopic examination, semitransparent, circular objects were discovered on the dentition, the mandible, tibial plateau, and distal femur. The objects were glycoproteinous adhesions deposited by the acorn barnacle, Balanus improvisus. B. improvisus is an intertidal barnacle found in estuaries in Galveston Bay. Basal diameter of the adhesions on the dentition were significantly smaller than those found on the postcranial bones (p = 0.010), indicating two consecutive cohorts adhered to the bone and dentition. As settlement typically occurs once a year, this would indicate that the remains were in the fluvial environment for at least 375-410 days. It is important in geographic areas that have prevalent fluvial environments that human remains, particularly dentition, are microscopically examined for marine life evidence.

Insect successional pattern of a corpse in cooler months of subtropical southeastern Texas.

Here, we characterize the cool weather insect fauna found associated with partially skeletonized and desiccated human remains recovered from an abandoned house in an urban area of subtropical, coastal Galveston County, Texas, and use the information to conclude an approximate postmortem interval of 7-10 months. The predominant factors that allow for a confident assessment of the postmortem interval include climatological data, entomological data, and anthropological data. The documented insect fauna represents a unique assemblage present in a particular environment (an urban abandoned house in coastal Texas) at a particular time of year (winter) and includes expected forensically significant insects such as calliphorid flies, muscid flies, and dermestid beetles but also includes less commonly encountered insects such as an unusually dense population of live case-making clothes moths.

Association between sudden death in infancy and co-sleeping: a look at investigative methods for Galveston County Medical Examiners Office from 1978-2002.

Our retrospective case review from 1978-2002, of infant deaths autopsied under the auspices of the Galveston County Medical Examiner Office, demonstrated a lack of detailed scene investigation, including sleeping circumstances and arrangements, as well as a pattern of ascribing the cause of death to SIDS even when there is evidence of a hazardous sleeping arrangement. During this period, 89/103 pediatric deaths were certified as SIDS and 39/103 of these were co-sleeping, 51/103 were sleeping alone, and 17/103 had no sleeping arrangement indicated. Upon review, there were only 6 cases where the scene visitation was documented. Only 9 cases used an Infant Death Investigation Form (IDIF), and this only started in 1999. The IDIF contains questions regarding the infants' sleep environment (bedding descriptions, co-sleeping, sleep surface) not used in the standard medical examiner death investigative forms. There has been an upward trend since the late 1990s in the number of scenes visited and detailed descriptions of the scenes, likely due to the increased awareness of hazardous infant sleeping conditions identified by American Academy of Pediatrics and U.S. Consumer Product Safety Commission. The association between co-sleeping and sudden infant death remains controversial among clinicians. We report a high association between these two conditions.