Suicide by self-inflicted stab wound of the chest

A case is presented in which a 44-year-old man stabbed himself in the heart with a kitchen knife, then changed his bloody clothes, and ate lunch with his aunt, who did not notice the event. After 2 h he died of cardiac tamponade.     

Unusual suicide caused by a stab wound in the neck

A case is reported of a man with a deep nape stabwound completely severing the medulla of the spine. A strangely formed bottle neck fragment is the assumed weapon. Further investigations allow a scene reconstruktion, police inquiries throw light on a previous acute psychotic disorder of the suicide.     

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。     

A transnasal intracranial stab wound by a plastic-covered umbrella tip

A 48-year-old man died from a transnasal intracranial stab wound caused by an umbrella. The track of the stab passed from the right nostril, through the sphenoid sinus, the left side of the sella turcica and anterior clinoid process, and finally reached the surface of the brain. The stab wound crossed the left internal carotid artery, causing an exsanguination and aspiration of blood into the airway, resulting in death. It is extremely rare that an umbrella tip used during a struggle would stab the nostril of the victim. Transnasal intracranial stab wounds can be overlooked and require sensitive handling.     

Case report of accidental stab wound to the heart

A 33 year-old Polish field-worker was found by his colleagues kneeling in front of his trailer, with a bloody stab wound in the heart region. In spite of prompt surgical intervention, the man died from his injury a few hours later. Upon examination of the dead man's trailer a blood-smeared vegetable-knife was found in the sink, and on the floor, a pullover with a slit-like cut. On the wall hung a jacket on a hook with a cut in the inner surface of the left breast pocket but not in the outside layer. The examination of the clothes, the autopsy and a reconstruction of the sequence of events led to the following conclusion: The knife had been placed into the breast pocket of the jacket with the tip facing downwards. As the man put down a sack of potatoes, the knife hooked into a pre-existing gap in the sack and was driven into the chest cavity by the pressure weight of the heavy sack.     

Thoracic stab wound caused by a grilling scewer with defomration of the tool

Injuries by meat- or barbecue-skewers are rarely relevant as cause of death. Besides accidental injuries they are used as coincidental tools in capital crimes. Skewers are non-typical stabbing tools of pointed-squared structure, which need considerable force to penetrate the skin. The authors report on a 42-year-old man's fatal thorax stab injury, which he sustained during a barbecue and which stretched from the left mamilla into the back right shoulder tissue. Death was caused by exanguination following stabbing through the superior vena cava. At issue was the question what amount of force was necessary to inflict the wound. Based on the deformation of the stabbing tool, as a result of a material-technical expertise, compressive load application in longitudinal direction and a stabbing force of between 120 to 665 N were to be assumed. Furthermore, in addition to the features of a non-typical tool, the autopsy findings allowed to conclude a powerful stabbing.     

Survival time in gunshot and stab wound victims

Forensic pathologists are often asked to estimate postinjury survival time and to render an opinion on the probable extent of physical activity following fatal injury. To study this question, the case files of the Dade County Medical Examiner's Office were reviewed. The year 1983 was chosen arbitrarily for this study and all the autopsy reports of gunshot or stab wound victims whose survival period satisfied criteria established for this study were reviewed. The data were compared to those from a similar study done in 1961. In addition, this study noted the presence and influence of drugs or alcohol on the cause of death and the postinjury survival time.     

Delayed pericardial tamponade following a stab wound to a branch of the right coronary artery

A 45-year-old man was attacked with a knife and suffered multiple stab wounds to the chest and abdomen. After surgical treatment and hospitalization for 9 days he was discharged in a stable condition. The following day he was found dead in his apartment. The autopsy revealed a pericardial tamponade caused by acute bleeding from an injured branch of the right coronary artery. This case shows that life-threatening late complications in patients with penetrating cardiac wounds may occur despite an initially uneventful course.     

Self-impalement after thoracic stab wound. An unusual method of suicide in psychotic symptomatology

A 35 year-old male was found dead within a vast collection of garbage in his parent's house with 13 stab wounds of the thorax. 6 years before death he had suffered from a severe cerebral trauma with intracranial hemorrhage, after which an organic psychosis had ensued. At autopsy besides the stab wounds measuring 1-3.5 cm in length and partly exhibiting a so-called "fish-tail" formation a piece of wood was detected, having penetrated the fourth intercostal space along the sternal border and lacerated the pericardium, right pulmonary hilum and the pleura parietalis at the paravertebral line between the eight and ninth rib. There the leading part of the tool had apparently broken and bent to the left in a nearly 90 degrees angle, thus penetrating the left pleural cavity with a slight laceration of the lower lobe of the lung. From the forensic pathologist's point of view this case of multiple stabbing and additional impalement was at least remarkable and at first sight might have raised a suspicion of homicide due to the extent of the rib penetrations and especially the intrusion of the wooden device, which had been pushed by substantial force into an already existing wound. The police presupposed a suicide based on the personal history and situation at the site, where no traces suggesting an activity of somebody else could be ascertained. Reconstruction of the case and resulting differential diagnostic considerations are to be discussed.     

Suicide by 120 stab wounds of the chest?

The case history of a suicide due to 120 stab wounds of the chest is presented. The victim was a 41 years old man with a paranoid-hallucinative psychosis. The problem to distinguish homicides and suicides is discussed by the well-known criminalistic and forensic-medical criterias. Induced by this very unusual case the autopsy material with stab wounds was analyzed retrospectively (n = 246, out of about 14,000 autopsies at the Institut of Forensic Medicine in Hamburg). Cases with more than 40 single lesions are normally homicides. However, the pattern of the injuries is more important than the number--especially in doubtful cases.     

Penetration of a piece of World War II rifle grenade initially suspected as a stab wound

The authors report the case of a 58-year-old man found dead by his son in the forest where he had gone to cut wood for winter. Initial examination showed an upper left laterocervical wound compatible with a stab wound. Radiography and autopsy performed the next day showed a piece of metal located in the left part of the occipital bone, associated with a half-ring fracture of the occipital bone and consequent diffuse subarachnoid hemorrhage. Death was attributed to a spinal shock after impact at the cervicocephalic junction. Investigators returned to the scene and found a few more metal elements and also a 20-cm deep and 40-cm wide crater underneath a fire the deceased had set. Army experts concluded that the metal pieces belonged to an ATM 9 antitank rifle grenade used by the U.S. Army during World War II. Death was considered accidental, the deceased having unfortunately set a fire over the grenade.     

Characteristics of stab wounds inflicted by knives with the gear-sharpened blade

The authors present the results of an experimental study designed to estimate the damage to biological and non-biological objects inflicted by the knife blades having the gear-type sharpening. It was shown that a knife with such sharpening leaves edges of the damage of characteristic shape and outline. The results of the study testify to the expediency of further studies on the damaging action of knives considered in the present paper.     

Homicide by stab to the neck with subsequent attempted suicide by cut to the neck

A 37-year-old Turkish woman was fatally injured by her 65-year-old Turkish husband with a stab to the cervical region. After her death he inflicted a deep cut to his own neck, which he survived thanks to immediate medical assistance. To the authors' knowledge this combination of a homicidal stab to the neck and a suicidal cut to the neck has not been described before. Kosher butchering, which is common in the couple's traditional cultural environment, is discussed as possible reason for the choice of the neck as site for applying sharp violence. It may have induced the perpetrator to choose this anatomical region.     

Simulation of an attack by self-mutilating cuts and stab wounds

Self-inflicted cut or stab wounds may be used by the injured to make credible a feigned assault. In such cases the alleged traces of the crime are found on the body and the clothing of the informant. Occasionally the very pattern of the injuries points to self-infliction. For example the following findings may be indicative of self-infliction: a greater number of very superficial wounds, wounds parallel or grouped, mostly located on the left side of the body (in right-handers) or symmetry in arrangement, intact clothing or lack of correspondence between wounds and damage of clothing, absence of typical defence and protection injuries. In the light of 4 cases observed from the material at hand, special features of the lesion appearance are shown and possible motives for the deed discussed.     

Suicide by skull stab wounds: a case of drug-induced psychosis

Suicide by stabbing to the head and/or driving sharp objects into the skull is of extreme rarity. This article reports the case of a 27-year-old man, who committed suicide by multiple knife stabs and cuts to the head, the torso, one shoulder and the forearms. Autopsy showed a perforating wound of the skull and the 10-cm long broken blade of the knife being still embedded in the right temporal lobe of the brain. The deceased had no history of psychiatric illness but was currently treated by mefloquine, a quinine derivative associated with a high rate of psychiatric adverse effects. Toxicological examination confirmed a recent intake of mefloquine together with chloroquine, another antimalarial drug. To our knowledge, this is the first report of a completed suicide with very strong evidence of mefloquine implication. Discussion focuses upon mefloquine-induced psychiatric disorders and highlights the importance of performing toxicological investigations in cases of unusual suicides.     

Forensic medical characteristics of stab wounds caused by objects differing in the blade sharpness

Based on the results of the present experimental study, morphological and histological criteria for incised skin wounds from objects differing in the blade sharpness were developed.