PubMed · 3347195
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W Massello. Lightning deaths.. https://pubmed.ncbi.nlm.nih.gov/3347195/
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Steamer accidents, through contact with the bucket wheel, are very seldom today. No publication of such a kind of fatal accident could be found in literature. We present the case of a fatal steamer accident, in which the findings of a blunt traumatization of a person by the ship was completely documented by post-mortem combined multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) examinations. A rupture of the aorta was detected using both radiological methods without use of radiopaque material. Radiological examination revealed a comminuted fracture of the thorax vertebrae at the same level as the aortic rupture. Injuries of the soft tissues of the back, caused by the bucket wheel of the steamer, were also diagnosed. In addition to the signs of blunt force trauma the findings of drowning such as an over inflation of the lungs, fluid in the stomach and duodenum were revealed. Furthermore, algological analysis detected diatoms in the lung tissue and blood from the left heart. Therefore, the cause of death was considered being a combination of fatal hemorrhage, caused by the aortic rupture, and drowning. We conclude that virtual autopsy using combined post-mortem MSCT and MRI is a useful tool for documentation, visualisation and analysis of the findings of blunt force trauma and drowning with a large potential in forensic medicine.
Central Forensic Science Laboratory (CFSL), Chandigarh undertakes the examination of the crime cases of some northern states of India. The shooting cases of last two decades (1980-1999) involving shotguns were analysed in this laboratory. This paper consists of the study of 360 actual cases of shotguns for evaluation of various parameters, such as type of firearm, number of firearm and firing, location of wound, age, occupation, sex and caste of accused and victim, etc. Out of 360 cases, 253 (70%) were classified as homicidal, 68 (19%) accidental, 11 (3%) suicidal, 9 (2.5%) hunting and 19 (5.5%) cases of insufficient information including the cases of illegal possession of firearm. Single Barrel Breech Loading (SBBL) gun 144 (40%) was preferred over Single Barrel Muzzle Loading (SBML) 109 (30.3%), Double Barrel Breech Loading (DBBL) 72 (20%) and Double Barrel Muzzle Loading (DBML) gun 35 (9.7%). All the breechloader guns were of 12 bore. Muzzleloader gun were recovered only from the remote rural areas. Three hundred and thirty-one (92%) cases involved single, 22 (6%) double and 7 (2%) more than two shotgun. Majority of cases were found of single firing 288 (80%), followed by double 29 (8%) and multi-firing 18 (5%). Eleven (3%) cases were of misfiring and in 14 (4%) cases information was not available. Accidental and suicidal cases had only one firing. The mean age for male and female victim was 31 and 24 years, respectively. Occupationally, agriculture is predominating over business, service and security guards for accused and for victim agriculture followed by service, business, student and security guards are in the descending order. Caste wise the most aggressive community of Kshatriyas is predominating as accused and victim over lower cast people. Head (64%) being a vital part was chosen most frequently for committing suicide followed by body (36%). Service personnel committed maximum number of suicide.
HISTORY AND ADMISSION FINDINGS: A 33-year-old drug addict injected accidentally into the femoral vein 5 ml urine (kept in the refrigerator for 1 week for unanticipated drug-screening) which she mis-took for methadone. Soon after injection she was found confused with shivering. On admission she had a blood pressure of 90/60 mmHg, heart rate of 120/min and fever of 40 degrees C. INVESTIGATIONS: Laboratory tests showed consumption coagulopathy (DIC) as well as leukopenia. Blood cultures were positive for E.coli and Klebsiella pneumoniae. Infection with hepatitis C and HIV was excluded. Echocardiography revealed good ventricular function without signs of endocarditis. DIAGNOSIS AND TREATMENT: The patient developed a fulminant Gram-negative sepsis with DIC and multi-organ failure. She was intubated and mechanically ventilated. Acute renal failure required haemodialysis and ultrafiltration. Septic shock was treated with fluids and high doses of vasopressors. DIC was effectively treated with tranexamic acid, PPSB complex and fresh frozen plasma. The further course was complicated by septic emboli to the myocardium, liver, kidney and spleen. Laparotomy because of an acute abdomen revealed perforation of terminal ileum (mainly due to ischemic bowel lesions) requiring partial resection. The patient was weaned on day 18 with an initially uneventful further course. On day 25 the patient had a cardiac arrest with at first successful resuscitation but electromechanical dissociation proved fatal on day 26. CONCLUSION: Although serious systemic inflammation associated with i. v.-injection in drug addicts is rare, one has to be aware of severe complications with septic emboli. To our knowledge it is the first published case of i. v.-injection of urine followed by sepsis and multi-organ failure. Aggressive interdisciplinary treatment is required.