Post-mortem radiological studies of the hyoid-larynx complex on excised specimens were undertaken. The post-mortem specimens were fixed to polysterene boards by ratio-translucent plastic pins. Radiological examinations revealed a fracture of the left greater cornu of the hyoid bone in a case of suicidal hanging; a fracture through the calcified right superior cornu of the thyroid cartilage in a case of blunt trauma to the left side of the head and neck; and a fracture artefact through the middle of the left greater cornu of the hyoid bone through compression of the structure by manipulation during the process of removal of the neck structures. In each instance the fracture sites were exposed and photographed. The use of a technique which permits a radiological examination of free dissected specimens of the hyoid-larynx complex has many advantages in the medicolegal investigations of injuries of the neck.

Forensic Medicine↗

PubMedDate not supplied

Endoscopic retrograde cholangiography in the diagnosis of biliary malformations in infants.

The differentiation of infantile biliary malformations from primary parenchymal diseases is difficult. The recent development of a pediatric side-viewing endoscope (PJF Endoscope; Olympus Corporation of America) provided an opportunity to investigate the usefulness of endoscopic retrograde cholangiography (ERC) for precise visualization of the extrahepatic biliary passages in infants with persistent cryptogenic cholestasis. ERC was performed in 12 patients, with visualization of the existing extrahepatic bile ducts in 4. The entire biliary system was visualized in one, excluding extrahepatic biliary atresia and choledochal cyst. The reduced caliber of the intrahepatic bile ducts and histological observations in a percutaneous liver biopsy supported the diagnosis of intrahepatic biliary hypoplasia in this case. An intact hepatic portochole cystostomy was documented in one, although the intrahepatic biliary system was not delineated. Atresia of the hepatic bile ducts proximal to the gallbladder was documented in two. Of the eight patients in whom extrahepatic bile ducts were not visualized by ERC, six had extrahepatic biliary atresia confirmed at exploratory laparotomy. The papilla of Vater could not be located in four of these six infants. The remaining two had neonatal hepatitis. ERC may offer a useful alternative to operative cholangiography in selected infants with persistent cholestasis and acholic stools.

Biliary Atresia↗

PubMedDate not supplied