特殊方式虐待儿童致死1例

1案例 案情：某女,8岁,某日在家中不明原因昏迷不醒,经抢救无效死亡。现场勘查除有一处呕吐物外无特殊发现。     

虐待伤致死1例

1案例资料某日,一女孩在某出租屋内死亡。经调查走访,死者郭某,13岁,聋哑人,数月前被骗入一聋哑人扒窃团伙,因不愿参加扒窃,被共同居住的团伙成员长期折磨体罚。尸体检验:儿童尸体,尸长142cm,发长12cm,体重30kg,发育正常,极度营养不良,舟状腹,头发稀疏,部分呈片状脱落(见图1)。尸斑浅淡,位于背部未受压处,双睑结膜苍白,双瞳孔等大等圆,直径约4mm。头左顶部见一大小6·5cm×2·5cm头皮裂伤,创口哆开,局部有血痂附着,前额部、双面颊部广泛分布形状大小不一、新旧不等的擦伤、烫伤及皮下出血(见图2);右耳廓青紫肿胀,触之有波动感;左耳背部见5cm…     

虐待儿童致死1例报告

虐待损伤具有病变的多样性、广泛性及新旧不一性等特点,与其它损伤有较大区别,现报告一例。丁某,女,５岁（１９９３年５月出生）,其母钟某为其算命后,得知其要克父母、克兄弟,因而经常对其殴打,有病不给治,经常饿饭,还用沸腾草药水热敷“治疗”皮肤病而烫伤皮肤...     

受虐儿童及青少年法医学鉴定92例分析

本文对92例不满18周岁家庭暴力受虐儿童和青少年法医学鉴定案例进行回顾性研究。结果表明：虐待行为多发生于下午5时前后，受虐者以女性居多（63．04％），损伤部位以头面部最多见（36．98％）。损伤类型以软组织挫伤最常见（51．13％），损伤具有多部位、广泛性、新旧不一等特点；发生场所以家中及家居周围附近为多，受虐者家庭情感生活环境差等.同时，作者还对虐待行为产生的社会根源、受虐儿童及青少年法医学鉴定及法律保护等问题进行了探讨。     

受虐待致死儿童的眼内改变

作者收集了美国洛杉矶市1984年4月至1987年2月受虐待致死儿童案例39例,非虐待致死对照73例。摘取双侧眼球在美国南加里福尼亚大学医学院眼科病理室进行组织病理学检查。在受虐待致死儿童中,发生眼内改变者约占64%。其眼内改变主要是视网膜各层的出血,玻璃体的出血,视网膜剥离,视神经乳头水肿或出血,视神经鞘内的出血和晶体的外伤性白内障。对照案例中,眼内有改变者约占28%。其改变主要为视网膜及其它眼内出血,视神经乳头水肿等,并多见于交通事故及其它易于引起头部外伤的意外。将受虐待致死小儿眼内改变与尸体解剖所见联系起来考虑,引起眼内改变的机理最重要的是头部的外伤及挥鞭样综合征。     

我国儿童虐待防治法律制度的完善

儿童虐待是一种严重侵害儿童身心健康的违法行为。我国规制儿童虐待的法律主要有专门性的《未成年人保护法》和《义务教育法》与非专门性的《宪法》、《刑法》、《婚姻法》等法律。儿童虐待防治法律制度存在立法形式分散,缺乏系统性;儿童虐待报告制度残缺不全;调查与处理制度暂付阙如及受虐儿童保护制度设计不合理等缺陷。借鉴域外经验,我们应将儿童虐待定义明确化、制定儿童虐待强制报告制度、设立儿童代理人制度、改革儿童收养与寄养法律制度并设立儿童虐待调查与处理制度。     

虐待儿童致胸腺萎缩2例

<正>1案例1.1案例1简要案情:某日中午,唐某(男,4岁)被发现死于某村民家中。据调查,唐某死前曾被其母亲的未婚男友灌酒、殴打,被发现死亡时其头面部浸在脸盆水中。尸体检验:尸长106 cm,发育正常,营养一般。尸斑浅淡,尸僵缓解。尸表可见多处皮下出血、表皮剥脱以及新旧程度不等的软组织损伤。头皮内面观可见与表面青紫色变及表皮剥脱区域相对应处有头皮下及     

信石误为滑石用药致死1例

1999年 1 0月 1 5日 ,丰都县一村民胡某 (女 ,60岁 )因腰部疼痛请该镇计划生育服务站聘请的医生陈某到其家为其诊治。 1 6日中午 1 2时许 ,陈将开好的中药处方交给该站药房工作人员由徐某配药 ,药配好后由陈某托他人带给患者胡某。 1 6日晚 9时许 ,胡在服药过程中 ,诉中药的味道不对 ,其丈夫试尝了一口 ,随后二人相继出现恶心、呕吐、腹痛、心慌等症状 ,亲属即去请医生 ,医生赶到时胡已死亡 ,其夫经抢救脱险。后经查明 ,该站在药物盘存时误将信石装入标有滑石的抽屉内 ,药房工作人员抓药时将信石 ( 30 ｇ)当作滑石发出 ,导致了这场悲剧的发…     

1例活埋致死案例报道

机械性窒息死亡的案例在各类非正常死亡中比较多见,但活埋致死的案例较为少见。作者将遇到的1例报告如下,并对其死亡机制、尸体现象及法医学鉴定做分析报道。     

对儿童虐待问题的认知研究

虐待儿童事件的频繁发生,使得儿童权益受到了严重侵害。在加强法律的监管同时有必要提高社会各界人群对儿童虐待的认知度。对儿童虐待的认识度和关注度越高,社会就越可能为预防儿童虐待,进而为保护儿童合法权益采取更为有效的措施。     

A case of panhypogammaglobulinemia masquerading as child abuse

A case of panhypogammaglobulinemia in a 15-month old boy is presented. The child was followed at a local university teaching hospital for pneumonia, failure to thrive, and possible child abuse/neglect. Following minor trauma to the face, massive sepsis developed in the child. The mother was afraid to seek medical care because she was fearful of legal action against her. Upon the child's demise at home, police and medical examiner involvement ensued. The correct diagnosis was established at autopsy.     

Childhood panhypopituitarism presenting as child abuse: a case report and review of the literature

Childhood panhypopituitarism may be acquired or congenital. Children with panhypopituitarism can present clinically with diabetes, growth failure, decreased bone density, and morbid obesity. In the forensic setting without the proper history, it can be misdiagnosed as child abuse or neglect. We report a case of a 3-year-old black girl who was admitted to the emergency room with apnea and subsequently died. While at the emergency department, it was discovered that the child had a fractured left hip and was severely growth retarded for age. The coroner wanted to rule out child abuse and/or neglect and requested an autopsy based on the physical findings identified by hospital staff. Significant findings at autopsy included small for age (15th percentile for age), hypoplastic brain/pituitary gland/adrenal gland/thyroid gland, abnormally formed skull with an occipital protuberance, a fractured left hip with decreased bone density, and central adiposity. Subsequent to the autopsy, it was discovered that at 6 weeks of age the child suffered from group B streptococci meningitis that resulted in panhypopituitarism. The panhypopituitarism then resulted in seizure activity, diabetes insipidus, and growth retardation. The authors hope this case report and review of the literature will assist investigators, pathologists, and clinicians in making a distinction between neglect or inflicted injury of child abuse and panhypopituitarism that can present with similar signs and symptoms.     

Case report: Forensic anthropological assessment in a suspected case of child abuse from South Africa

Not many case reports of suspected child abuse as assessed solely on skeletal remains are available. Forensic anthropologists have intimate knowledge of normal skeletal anatomy, bone trauma and processes of healing of bone and may therefore be of help in suspected cases of child abuse. Patterns of trauma in juvenile skeletal remains which are suggestive of abuse include fractures in different phases of healing, multiple fractures, typical fractures on ribs and long bones and severe, complicated cranial fractures. The aim of this paper is to report on the findings of the analysis of the skeletal remains of a 3.5 years old boy. Forensic pathological examination indicated that the boy had died from a massive cranial fracture, with multiple injuries present to the rest of the body. After the body had been buried for some time, it was exhumed and we were requested to look for signs of chronic, long-term abuse. Findings included a massive cranial fracture, another fracture in the roof of the orbit, two areas of non-specific subperiosteal bone growth and several untreated carious teeth. No clear healed fracture could be found, except for a possible healed cranial base fracture which stretched transversely across the petrosal bone. This area showed signs of recent bone activity. The court decided that this was not enough evidence of chronic abuse and found the accused guilty of murder but not of chronic child abuse. This case illustrates the difficulty to obtain clear signs of chronic injury on juvenile remains.     

A case of traumatic osteomyelitis in a victim of child abuse

A premature black female infant born at 31 weeks gestation with history of 4 weeks in the newborn intensive care unit was discharged healthy to the care of her mother and was lost to follow-up. At age 4 months the infant was found dead in bed. There was no history of trauma and no external injuries were noted. There was no attempt at resuscitation. Coroner's autopsy showed acute bronchopneumonia, 3 partially healed skull fractures, a chronic subdural hematoma, chronic intracerebral hemorrhage, retinal hemorrhages, multiple healing rib fractures, a fractured fibula, and a partially healed fracture of the distal right radius. The fracture of the right radius showed a medullary abscess of the bone surrounded by scar tissue and containing pus and granulation tissue. We believe this inflicted fracture became secondarily infected by a hematogenous route. The final diagnosis of the cause of death was pneumonia secondary to multiple blunt force trauma, and the manner of death was diagnosed as homicidal. This is believed to be the first reported case of osteomyelitis in a context of child abuse.     

A death due to ethchlorvynol abuse. A case report

A fatal case of ethchlorvynol abuse is reported with blood and tissue determinations.     

Caffeine toxicity: a case of child abuse by drug ingestion

The case of a 14-month-old child who died of caffeine toxicity is presented. The evidence for prolonged toxicity associated with inappropriate delay in the seeking of medical care and the presence of various recent and healing injuries are diagnostic of child abuse. Fatal caffeine toxicity and child abuse by drug/substance administration are uncommonly reported. Relevant medical literature is reviewed.     

An unusual case of child abuse homicide/suicide

This case report examines a child abuse homicide in which the perpetrator committed suicide a few hours after the infant's death. At the time of the perpetrator's suicide he was not under investigation, nor was he a suspect in the death of the child. Although the literature does not contain reports of similar cases, we are sure they exist. This report raises the question of the degree of social stigma attached to the accusation of child abuse. It also serves as a warning to those who must deal with the potentially suicidal child abuser.     

Laceration of the stomach by blunt trauma in a child: a case of child abuse

A case of perforation of the stomach following blunt abdominal trauma is described in a two-year-old boy. The abdominal trauma was the result of a blow to the abdomen by the stepfather. The child had ingested a large meal in the hour preceding the injury. The child died from peritonitis and shock 12 h following the injury. The literature on gastric perforation by blunt trauma is reviewed. Injuries to the stomach from nonpenetrating trauma are quite rare and are most often related to vehicular accidents. Gastric injury in a child presenting with a history of a minor home or play injury should arouse suspicion of more significant and perhaps intentional trauma.     

Nonfracture-associated fatal fat embolism in a case of child abuse

Fatal fat embolism is usually thought of as a sequel to long-bone fracture, although cases secondary to soft tissue injury and atraumatic conditions have been infrequently reported. In this case of a two-year-old child-abuse victim who sustained multiple blunt traumatic injuries without skeletal fractures, pulmonary and systemic (brain and kidney) fat emboli were identified. At autopsy, all thoracic and abdominal viscera were intact; cranial contents exhibited only diffuse symmetrical petechial hemorrhages of the white matter. Because of the severe and widespread nature of soft tissue hemorrhage, and the absence of a grossly discernible cause of death, fat embolism was suspected. Using a combination of frozen section with oil red O staining and formalin-fixed osmium stained tissues, the immediate cause of death was determined to be diffuse fat embolism. Review of the literature reveals a pathophysiologic basis for fat embolism in the absence of fracture, both as a consequence of an acute increase in local pressure at the site of trauma and an alteration of the emulsification of blood lipids during shock. In light of these findings, we present this case to remind the forensic science community to consider fat embolism as the cause of death in cases of blunt-force injury without fracture.