Review of patterns in homicides by sharp force: one institution's experience.

This paper presents a retrospective review of patterns found in cases of homicides by sharp force over a 13-year period at the Department of Forensic Pathology of the Ostrava University Hospital, Czech Republic. The review summarizes all frequently discussed aspects of such cases including the number and localization of injuries, the presence of defensive wounds, the type of the offending weapon, the cause of death, the place of death, victims' and perpetrators' profiles, their relationship, or toxicological findings. Furthermore, special attention was paid to the evaluation of any accompanying blunt force trauma that may be indicative of an escalation of the assault. The set of data was statistically analyzed. Even though most of the results of this review are consistent with available published studies, noteworthy differences have emerged in some aspects such as the sex and age of the victims, the relationship between the number of injuries suffered and the victims' sex, or the severity of alcohol intoxication in victims.

Toluene abuse as a contributing factor in a case of fatal autoerotic asphyxia.

Autoerotic asphyxia is a form of deviant sexual behavior that seeks sexual gratification by means of manipulation with one's own body resulting in asphyxia, and may sometimes turn out to be fatal. Autoerotic fatalities involving autoerotic asphyxia are divided into two groups: "typical" autoerotic fatalities involve mechanical compression of the neck, chest or abdomen, whereas "atypical" autoeroticism involves sexual self-stimulation by other means. Cases where asphyxiophilic behavior is accompanied by volatile substance abuse are reported to be rather rare, but may involve a high risk of fatal results. This paper presents a case of accidental "atypical" autoeroticism involving victim's abuse of toluene, which, combined with asphyxiophilic airway occlusion, led to death. For the sake of comprehensiveness, both a verbal description and a schematic representation of the major metabolic pathways of acute and chronic abuse metabolic markers is provided.

Giant cell aortitis.

Inflammatory aortic diseases are broadly classified into three categories according to the degree of inflammation: atherosclerosis, atherosclerosis with excessive inflammation, and aortitis/periaortitis. This paper presents a case of a 39-year old man with aneurysmal dilatation of thoracic aorta and aortic valve insufficiency. The aortic wall showed thickening and wrinkled "tree bark" appearance as well as apparent scarring of the intima. Histological examination revealed intimal hyperplasia, a granulomatous/giant cell pattern in the inner tunica media, a few epithelioid macrophages, abundant chronic lymphoplasmacytic and histiocytic inflammation and discrete fibrinoid necrosis. The histological findings were indicative of Horton's disease, but no typical clinical features were present. The case illustrates the difficulties involved in diagnosing inflammatory aortic diseases where it may be challenging to arrive at a specific diagnosis despite the knowledge of medical history, and available macroscopic and histological findings.

Fatal and Nonfatal Rip Saw Injuries.

This paper deals with a fatal stab wound suffered by a 29-year-old man and nonfatal injuries of 35-year-old and 67-year-old saw operators. Rip saw is a machine that is specially designed for making a rip cut, a cut made parallel to the direction of the wood grain. Rip-saw-related injuries mostly occur when a person is struck by the cutting material, which usually involves splinters of irregular shape and diameter. When the splinter strikes the body diagonally, the injuries may include abrasions, lacerations, and cut wounds; in situations where the victim is struck directly, the most common injuries are oval- or star-shaped stab wounds with a varying width of abrasions around the wounds. Therefore, such injuries may come across as injuries produced by a knife-like instrument, which is an added difficulty in the interpretation of such injuries.

Necessary Defense or Homicide?: The Importance of Crime Scene Reconstruction in Crossbow Injuries.

Reconstruction of a criminal offense is a crucial approach in forensics and criminalistics allowing for the verification of the location, the particular method used, or the use of a specific instrument. This report describes the case of a young man who was killed by an arrow shot from a crossbow. The autopsy revealed a penetration of the head and significant damage to the brain stem. Although the cause of death was evident from the outset, it was necessary to clarify whether or not the arrow was shot as necessary self-defense. Ballistic investigation of the seized weapon and reconstruction of the crime was absolutely essential to bring forth conclusive evidence to convict the perpetrators of the murder.

Axe injury pattern in homicide.

Chop or slash wounds are produced by sharp-edged tools such as an axe, or a machete. This paper presents a case of a violent death of a 57 year-old-man. Autopsy revealed deformation of the right side of the head. A total of 23 slash, stab and cut wounds as well as contused lacerations were identified on the scalp as well as the face and the neck. In addition, superficial abrasions and bruises were identified on the skin. The immediate cause of death was due to extensive brain contusion following fragmentation of the neurocranium. The injuries resulting in the death of the victim were sustained during an assault on the head with an axe, which was used both as a slashing tool and a blunt instrument.

Fatal delayed hemopericardium and hemothorax following blunt chest trauma.

Cardiac injury following blunt chest trauma is common in motor vehicle accidents due to a crush or blast injury. Severe cardiac trauma is associated with a very high mortality. If a cardiac injury develops several weeks after non-penetrating chest trauma, establishing a causal link between the traumatic event and the cardiac injury becomes complicated. This article reports a case of fatal delayed hemopericardium and hemothorax following a motor vehicle accident including blunt chest trauma 34 days prior to death. The cardiac injury was caused by displacement of a sharp irregular fragment of one of the decedents fractured ribs and the primary defect was sealed by blood clots. Subsequent bleeding occurred when the thrombus was displaced. Since the incidence of blunt high-energy chest injuries is relatively high, heart and large vessel injuries must be taken into account and a comprehensive examination needs to be done in order to prevent the delayed development of fatal complications.

Death of a Female Prostitute Due to Intestinal Obstruction by an Unknown Substance.

A young adult black female, known to be a prostitute and suspected of smuggling narcotics, was found dead in her apartment in a state of early decomposition. Oval-shaped gray-white masses of exogenous origin protruded from the anus. The autopsy showed dilatation of the folds of the large intestine, which were almost completely filled with these oval-shaped gray-white masses of foreign material. The uterus was enlarged with multiple large leiomyomas. Toxicological tests of blood and the foreign material revealed no toxicologically relevant substances. Kaolin was detected in a sample of the foreign material from the large intestine. The immediate cause of death was intestinal obstruction due to the formation of a kaolin bezoar with simultaneous compression of the large intestine by the enlarged myomatous uterus. Subsequent revelation of a habit the deceased had brought from her native country led to the conclusion that this exotic custom was responsible for her death.

Fatal deer attack in a rutting season.

Animal inflicted fatal or near fatal injuries are well described in the forensic literature, with the most frequently described cases involving dogs, large cats and bears. To our knowledge, a deer inflicted fatality has not been described in the forensic literature previously. This article reports a case of a 64-year-old male, who was found lying in a pool of blood near an enclosure for stags and hinds at the end of October. There were mechanical defects on his jacket and trousers, which appeared to be torn or penetrated, as well as multiple lacerations and stab wounds in different parts of his body. The type and location of the injuries the man had sustained strongly suggested that another person had been involved in the incident that had led to his death. The cause of death was deemed as external exsanguination due to multiple stab wounds to large vessels. After evaluating all of the information regarding the circumstances around the death, the case was classified as a deer attack related fatality, and the manner of death was determined to be accidental. The man was most probably attacked by one of the deer while he was refilling the animal feeder. A substantial increase in the levels of selected hormones, especially testosterone, during the rutting season explains the increased levels of aggression shown by the deer that led to a fatal outcome for the decedent.

Stab wounds of the chest caused by penetration of duralumin rods.

Sharp force injuries are uncommon in routine forensic practice. While the majority of these cases are homicides or suicides, a significant minority of accidental deaths means that a careful investigation of the circumstances of the death is necessary. We present the case of a young man who presented with stab and cut injuries due to a duralumin rod embedded in his chest. Examination of the body revealed that death was due to penetration of the thoracic aorta by a duralumin rod. Careful investigation of the circumstances surrounding the death was able to confim a case of accidental death due to falling from a ladder onto tomato seedlings that were supported by duralumin rods.

Fluid content in the pleural cavity protects internal structures against heat.

PURPOSE: In this paper we present a case report of two people who were found dead in a holiday cottage after a fire. The cause of death in these cases was clarified by the presence of blood in the left pleural cavity in both bodies. METHODS: An inspection of the bodies at the scene of the fire and subsequent examination by a medical examiner suggested the deaths were accidental. RESULTS: An autopsy showed that the bodies were those of a man and a woman with severe carbonization of the skin, soft tissues, brain, and some organs of the thoracic and abdominal cavities. There were also isolated stab injuries to the chest, as well as injuries to skeletal structures and intrathoracic organs. The accumulated blood in the pleural cavity had protected the internal organs against thermal destruction and preserved the traumatic findings. CONCLUSION: To the best of our knowledge this is the first description of the protective effect of hemothorax against thermal damage of the intrathoracic organs.