根据损伤照片推断致伤物1例

1案例资料1.1简要案情程某,男,33岁,左胸部被刺伤死亡。据卷宗原鉴定书记载,程某左胸部创口呈梭（双弧）形,长2.4cm,宽1.2cm,深10cm,推断该伤为刃宽2.4cm左右的单刃刺器所形成。嫌疑人提供成伤物为宽3.0cm的单刃刺器。由于刀宽明显大于刺创口长度,辩护人提出该伤不是嫌疑人所为,要求重新鉴定程某左胸部创口是否该刺器形成。     

根据双刃刺器刺创口推断刺器宽度

解决根据皮肤创口推断刺器宽度的问题。实验在自愿捐献的12具男性尸体的胸部,用不同宽度和厚度的双刃匕首致创221个。应用法医学、解剖学及数理统计的理论和技术对创口形成机理、影响因素及其与刺器宽度的相关关系进行分析,得出了以下结论：刺器厚度与创口长度无明显相关,刺器宽度与创口长相关,创口回缩程度与创口方向及刺器宽度相关。并建立了两个最优回归方程,提出了一个根据皮肤双刃利器创口推断刺器宽度的方法。     

创口长度短于单刃刺器宽度鉴定1例

在法医实践中，单刃刺器形成短于刃宽的创口常引起争议，笔者试分析1案例供同仁们参考。     

刺锯器刺破纺织物分析

刺器按有无刃部可分为有刃和无刃两类。有刃刺器按刃的多少又可分为单刃、双刃和多刃３种。单刃刺器背部形态有平、圆之分（可合称为普通单刃刺器），另外还有一种背呈锯齿状的单刃刺器，它的形态介于普通单刃与双刃刺器之间，可称之为刺锯器，其刺破纺织物形成的破口可称之为刺锯口。刺锯器与普通单、双刃刺器刺破纺织物形成的破口既有相同之处又有不同的表现。笔者通过办案收集的资料来阐明刺锯器的构造、刺锯口的形态特点及其形成机理，并与普通单、双刃刺器及三棱刮刀相鉴别，为此类工具的推定提供依据。１刺锯器的构造刺锯器由尖、刃、…     

关于变异型刺创形成机制的研究附380例刺创分析

本文通过380例刺杀案中823个创口的分类统计分析,结合动物实验,研究了单刃、双刃、三棱、四棱四种刺器造成变异型刺创的形成机制。并对刺创的检验方法进行了探讨。     

根据衣服刺创口痕迹推断刺切顺序与刺器宽度

在法医检验鉴定中，常利用体表刺创口形态分析判断刺切的先后顺序与刺器宽度，但由于受人体皮肤组织状态、肌肉回缩和死后尸体腐败等因素影响，从而导致利用人体刺创口形态判断创口形成顺序与刺器宽度存在误差。而衣服上刺创口与体表上刺创口相对比，因其组织形态和腐败因素较之体表创口具有更稳定的特点，所以本研究依据衣服上刺创口痕迹来判断刺切顺序与刺器宽度。     

90例刺杀致死案件回顾分析

<正>刺杀案件在刑事案件中比较多见，该类案件中刺器种类的确定对案件的侦破比较重要，然而，由于同一把刺器在不同的情况下可以形成不同形态的创口，而不同的刺器可以形成类似的创口，这给我们判断刺器的种类增加了难度。     

三例单刃刺器致伤特点分析

刺创的检验中,常需对致伤工具的特点作出分析,如有无刃部,单刃或是双刃,我们在尸检中发现单刃刺器的刺创常出现变异的复杂形态,本文报告3例,并对如何排除干扰,正确推断刺器特征试作分析。案例资料例1　男,32岁。尸检发现背部一处刺创,创角呈双侧钝角,用放大镜仔细观察,其中一个创角呈“Ｗ”形,是两个小锐角融合形成。结合衣物刺破口,并检验肌层,肺脏刺创均为创角一钝一锐,确定为单刃刺器致伤,破案后证实推断正确。(照片1)　　例2　女,41岁。尸体上检见多处刺创,仅其中一处创角呈双侧锐角。仔细核对衣服上对应刺破口为一角钝一角锐,相应软组…     

三例单刃刺器致伤特点分析

刺创的检验中,常需对致伤工具的特点作出分析,如有无刃部,单刃或是双刃,我们在尸检中发现单刃刺器的刺创常出现变异的复杂形态,本文报告3例,并对如何排除干扰,正确推断刺器特征试作分析.     

玻璃刺创形态学特点的初步研究

目的研究玻璃刺创的形态学特点。方法分别用3个厚度为0．31cm带尖状突起的啤酒瓶残端及3块厚度为0．29cm有尖的普通窗玻璃碎片按设定的不同方向刺击带皮猪肉组织,重复此过程3次,形成198例创口,观察、编号、拍照、测量各创口。结果198例创口的整体形态可分为5种类型,即“工”型、“”型、“”型、“上”型与“一”型,各型在不同刺击方向的分布上存在差异,其中前4种为主要类型,共约占总数的93％,其共同点为在损伤的中部出现了一段与损伤整体走向垂直的创口,啤酒瓶残端所致垂直创口的长度为0．31±0．Olcm（x±s）,窗玻璃碎片所致垂直创口的长度为0．29±0．Olcm（x±s）。结论损伤中部有与损伤整体走向垂直的短创口是玻璃刺创中易出现的一种形态学特点,垂直创的长度与致伤玻璃的厚度具有一致性。     

捅创论(附尸检例报告)

无尖无刃的细长钝器,沿其长轴戳入人体形成的创伤应命名为捅创。国内外现有的法医学书籍很少甚至没有描述过此创,个别作者将其归入锐器刺创。本文作者通过案例研究发现:不仅该创的致伤物为无刃无尖的棍棒类钝器(如木棍、木桩、手杖、擀面棍、铁锹把、竹竿、筷子、钢筋)而且成伤机制、形态学变化也与锐器刺创不同,应属于钝器伤。     

Atypical Suicide by Submachine Gun

In case of suicide, the presence of multiple entrance wounds is always suspicious. We report the case of a man who committed suicide by shooting himself three times in the chest and the skull with a submachine gun. The weapon seems to have been initially pointed in the precordium area with a lethal lesion of the proximal aorta. Two other projectiles were fired by the weapon and hit the neck and the skull of the deceased. The presence of three entrance wounds despite a first fatal wound could finally be explained by the characteristics of the weapon and wounds. Most suicides related to multiple gunshot wounds are explained by a first nonlethal shot but the use of an automatic weapon can also be found. In these last cases, medicolegal and criminalistics aspects become important in differentiating suicide and homicide.     

An experimental model of tool mark striations in soft tissues produced by serrated blades

Stab wounds produced by serrated blades are generally indistinguishable from stab wounds produced by non-serrated blades, except when visible tool mark striations are left on severed cartilage. We explored the possibility that similar striations may be produced on the soft tissues of internal organs. Loin of beef, bovine kidney, and pig heart, liver, and aorta were each stabbed 20 times with a coarsely serrated blade. The walls of the stab tracks were exposed and documented by photography, cast with dental impression material, and the casts photographed. Striations were identified in all of the tissues in every stabbing, but their consistency and quality varied between tissues. Striations were most easily seen in liver, heart, and aorta. Tool mark striations in soft tissues other than cartilage have not been described in homicidal stabbings, likely because they have not been sought. We suggest that the walls of stab wound tracks should be exposed, and tissue striations should be sought as a means of identifying the weapon as having a serrated blade.     

Homicide attempt with a Japanese samurai sword

The use of Japanese swords for homicidal attempts is rare. A Japanese samurai sword is a sharp and cutting object. When faced with the use of this weapon, one must distinguish between stabs and incised wounds. Incised wounds can rarely lead to death, but because of the size of the weapon, stabs usually cause much more serious injuries. Stabs also imply a penetrating movement, whereas incised wounds can be the consequence of protective circular blows. Therefore, it is important to distinguish clinically between these two kinds of wounds. We report a case where the perpetrator argued he had given a circular blow, unfortunately hitting the victim. The pieces of evidence are discussed.     

Homicide by unusual‐edged weapons: Forensic considerations of two cases

Homicide by stab wound is common worldwide. However, the use of unusual edged weapons is rarely reported in the forensic literature. Here, we report two cases of homicide involving a Japanese sword, or katana, and a sickle. Both of these weapons can create either stab or incised wounds with some particularities. In our cases, characteristics of the external wounds, internal injuries, and the depth of penetration raised the possibility of an unusual weapon. Meticulous forensic examination of these injuries (morphological characteristics, depth of penetration, trajectories, and cut marks in the bone) may allow the forensic expert to determine the type of weapon used.     

Rifle wounds: a review of range and location as pertaining to manner of death

Given the prevalence of rimfire and centerfire rifle usage in both suicidal and homicidal cases, there is a paucity of articles in the literature that focus specifically on rifle wounds. Gunshot wounds, in general, have been extensively studied with articles focusing on the types of injuries, weapons used, wound locations and weapon range. We designed a study to examine the characteristics of rifle wounds, including both centerfire and rimfire rifles, especially pertaining to location and range of the wound. All deaths due to rifles examined at the Bexar County Medical Examiner's Office between 1988 and 2004 were reviewed. A total of 509 cases were identified, with 233 suicides and 266 homicides. We found that the average age of suicide victims (41.6 years) tended to be older than that of homicide victims (32.6 years). Suicides tended to be contact wounds to the head whereas homicides most often had multiple wound locations sustained from a distant range. The most common location to the head of suicidal wounds was intraoral whereas homicidal head wounds were more often to the temporoparietal region. We developed odds ratios for assessing the manner of death given a wound location or range; however, we caution that every case should be analyzed based upon it's unique circumstances and not solely its statistical probability.     

Patterns in sharp force fatalities--a comprehensive forensic medical study: Part 2. Suicidal sharp force injury in the Stockholm area 1972-1984

A total of 89 cases of sharp force suicide that had been committed in the Stockholm area in Sweden from 1972 through 1984 were investigated. The series showed a male preponderance, sex ratio 3.3, and among males a shift towards the age group 40 to 49 years of age. An impact of cultural/ethnic factors was indicated by the overrepresentation of Finnish and Hungarian immigrants. A psychiatric diagnosis had been ascribed in 22 cases, and addiction to drugs or alcohol in 23. Previous attempts at self-destruction were recorded in 11 cases, only 1 of which was by sharp force. Classical indicators of suicidal intent, for example, suicide notes and the presence of hesitation injuries, were found in 28 and 80%, respectively. A preference for certain anatomical locations (throat, precordium, epigastrium, wrists) was confirmed as was the tendency to expose the skin before inflicting suicidal wounds. As compared to homicidal precordial stabs whose entrance wounds usually run vertically, horizontal or upwards/left-slanting stabs are strongly suggestive of suicide. Although cases were encountered where several "rules of thumb" concerning homicidal versus suicidal patterns were violated, our series contained no case of injuries to the backside of the trunk and no case of more than one wound piercing the left ventricle of the heart. Multiple chest wounds transecting costal or sternal bone were however not uncommon, and, along with the use of bizarre tools and objects like wood chisels or pieces of glass, illustrated the determination of suicidal intent. Toxicological analysis was positive for drugs in 22 and for alcohol in 27 cases. Blood alcohol levels were roughly similar to those found in victims of homicidal sharp force, whereas drug levels tended to be lower or higher in suicides.     

Striation patterns in serrated blade stabs to cartilage

Stab wounds were made in porcine cartilage with 13 serrated knives, amongst which 4 were drop-point and 9 straight-spine; 9 coarsely serrated, 3 finely serrated and 1 with mixed pattern serrations. The walls of the stab tracks were cast with dental impression material, and the casts photographed together with the knife blades for comparison. All 13 serrated blades produced an "irregularly regular" pattern of striations on cartilage in all stabbings. Unusual and distinctive blade serration patterns produced equally distinctive wound striation patterns. A reference collection of striation patterns and corresponding blades might prove useful for striation pattern analysis. Drop-point blades produced similar striations to straight-spine blades except that the striations were not parallel but rather fan-shaped, converging towards the wound exit. The fan-shaped striation pattern characteristic of drop-point blades is explained by the initial lateral movement of the blade through the cartilage imposed by the presence of the drop point shape. It appears that the greater the overall angle of the drop point, the shorter the blade length over which the drop point occurs, and the closer the first serration is to the knife tip, the more obvious is the fan-shaped pattern. We anticipate that micro-irregularities producing individualising characteristics in non-serrated drop point blades, provided they were located at the tip opposite the drop point, should also show a fan-shaped pattern indicative of a drop point blade. The examination of the walls of stab wounds to cartilage represents an under-utilised source of forensic information to assist in knife identification.     

Suicide by hara-kiri: a series of four cases.

The authors describe four cases of suicide by hara-kiri. This very painful form of suicide consists of self-inflicting a wound in the abdomen using a sharp instrument. It was first reported in 988 A.D. in the East but has now become rare in both the East and West. These four cases occurred over a 40-year period in the Trieste and Bari medicolegal area. In two of our cases the victims were afflicted with mental illness, whereas the other two suffered from depression. In cases of death by hara-kiri, it is important to establish a differential diagnosis between suicide and homicide; the presence of trial wounds (inflicted by the victim as a form of practice to overcome any hesitation before stabbing the abdomen with the cutting weapon) can prove very helpful.     

Intracranial stab injuries: case report and case study

Non-missile penetrating brain injuries are rare events in western countries. We report a case with lethal stab injury of the brain and identification of the weapon used in the assault by digital superimposition on CT scans taken at admission of the victim to a hospital. Furthermore, all cases with knife stab wounds of the skull between 1971 and 2000 were analyzed and compared with literature reports. Results of this study show that there is no region preference despite of differences in bone thickness, that stab wounds of the brain are almost invariably associated with multiple stab wounds to the trunk and that the wound tract may correspond to the dimensions of the blade allowing the identification of the weapon by digital image analysis.