A Rare Presentation of Sudden Death due to Pulmonary Thromboembolism Possibly as a Result of Giant Hepatic Hemangioma

Hepatic hemangiomas are usually detected incidentally when investigating for other nonrelated pathologies. When symptomatic, they are usually large and cause symptoms such as abdominal discomfort or other digestive issues. Occasionally, uncommon presentations such as bleeding with coagulopathy (Kasabach–Merritt syndrome) or even fever of unknown origin may occur. As hepatic hemangiomas are benign, they do not result in tumor emboli and pulmonary thromboembolism due to hepatic hemangiomas is extremely rare. This is a case report of a rare case of a female with no known past medical history who presented with sudden death due to pulmonary thromboembolism, possibly as a result of an underlying giant hepatic hemangioma. Incidentally, she also had three other tumors—pancreatic cystic lymphangioma, cerebral capillary telangiectasia, and papillary thyroid carcinoma, and their potential contribution to the cause of death will be discussed.     

Femoral artery pseudoaneurysm and sudden death

Pseudoaneurysm formation may be a late complication of vascular grafting. A case of sudden death in an 83-year-old woman with a previous aortobifemoral bypass graft is reported that was due to spontaneous hemorrhage from a pseudoaneurysm of the graft site that had eroded through the overlying skin and subcutaneous tissues. Pseudoaneuryms do not have to be of a particularly large size for rupture to occur. Social isolation and age-related cognitive impairment may delay treatment in older individuals resulting in a lethal outcome. The elderly are also more vulnerable to serious morbidity and death under these circumstances owing to significant underlying cardiovascular and respiratory disease and/or anticoagulant medication. Rarer conditions that may cause pseudoaneurysms include tumors and vasculidites. The possibility of an infectious contribution to the pseudoaneurysm should be considered and microbiological sampling undertaken.     

Sudden death owing to right atrial hemangioma

Primary cardiac tumors are rare, with an autopsy incidence of 0.03%. Seventy-nine percent to 85% of primary cardiac tumors are benign, and of the benign tumors, cardiac hemangiomas account for 5-10% of cases. Most cardiac hemangiomas are asymptomatic and are discovered incidentally at autopsy, or by echocardiography, computerized tomography, or magnetic resonance imaging. We report a case of sudden death owing to cardiac hemangioma in a 22-year-old woman who collapsed while shopping and became unresponsive. The autopsy revealed a hemorrhagic mass on the surface of the right atrium which was infiltrating and replacing the wall of the right atrium; histopathological examination confirmed the tumor was a cavernous hemangioma. Fewer than 20 cases of right atrial cavernous hemangiomas have been reported in English literature, emphasizing the rarity of our case.     

Sudden, unexpected death in a 5-year-old boy with an unusual primary intracranial neoplasm. Ganglioglioma of the medulla

This report documents sudden, unexpected death in a 5-year-old boy from a ganglioglioma of the medulla. Gangliogliomas are rare, primary brain tumors that are encountered predominantly in childhood. We are unaware of any previous report of a similar case.     

Sudden asphyxial death due to a prolapsed esophageal fibrolipoma

Fibrolipomas of the esophagus are extremely uncommon benign tumors. Accurate diagnosis and resection are essential, due to their tendency to become impacted and obstruct the airway. The case is presented of a 56-year-old man who died suddenly of asphyxia because of upper airway obstruction by a prolapsed fibrolipoma of the esophagus.     

“杀亲案件”135例法医学回顾分析

目的通过总结我省135例杀亲案件的案件资料,研究杀亲案件的特点,分析杀亲案件的侦办要点。方法收集2011~2013年间我国中部某省区域内发生的135例杀亲案件,对数据资料进行分析。结果杀亲案件主要发生在夫妻之间及父母子女,好发于农村,青壮年多见。一般无明显杀人动机,作案工具多为就地取材,死亡原因以机械性损伤和机械性窒息为主。结论杀亲案件在嫌疑人社会学特点、致伤工具、死亡原因、案发时间等方面反映出一定共性,但案件证据的收集是案件的侦办难点。     

Blunt pancreatic trauma by a wheelchair user restraint system during a traffic accident.

Traffic accidents are the most common cause of blunt pancreatic trauma, and most injuries occur in unrestrained drivers. Blunt pancreatic trauma in a passenger or a restrained driver is rare. In this report, we describe a case of blunt pancreatic trauma caused by a restraint system for wheelchair users during a traffic accident.     

Comparative characteristics of chest cavity injuries in children and adults as a result of a blow from a solid blunt object

Deformity character and mechanism of thoracic injury occurrence in children regarding different variants of striking effect of solid blunt objects were studied. It was found that the bone frame of a middle part of rear and lateral surfaces of thorax is most often damaged and isolated incomplete fractures of 2 to 9 ribs occur (in adults - multiple, complete fractures). In case of wide striking surface 3 to 10 ribs are injured both in children and in adults, and construction flexion fractures are noted while in case of blows with limited surface local extension fractures with injuries of up to 3 adjacent ribs are seen.     

Hypopharyngeal lipoma as a cause for sudden asphyxial death

Lipomas of the hypopharynx are uncommon tumors that are rarely life threatening. When positioned in the hypopharynx, asphyxia may be the result of the tumor size or sudden displacement into the oropharynx. We present a case of a large hypopharyngeal lipoma, review the literature, and discuss mechanisms by which these lesions may cause sudden asphyxial death.     

Severe Cardiac Rupture by Only One Blow to the Chest in a Young Boy: An Autopsy Case

Cardiac rupture by blunt chest trauma is commonly seen after motor vehicle accidents and falls; however, it is rarely caused by a blow to the chest. We herein report an autopsy case of a high school boy who sustained severe right ventricular rupture by only one knee kick to the chest during a quarrel. He was hospitalized and developed cardiopulmonary arrest. Emergency surgery was performed, but the patient died. The autopsy revealed no external severe trauma or deformation, but the side wall of the right ventricle contained a large V‐shaped laceration. The other thoracic organs had no injuries. This case illustrates that severe cardiac rupture can occur by only one blow to the chest. Blunt cardiac injuries can occur even if no severe injuries are present on the body surface. We should consider the possibility of severe cardiac injuries regardless of the presence of external injuries.     

When Children are the Least Vulnerable to False Memories: A True Report or a Case of Autosuggestion?

In this case report, a legal case revolving around the reliability of statements given by a 6‐year‐old girl is described. She claimed to have witnessed her mother being murdered by her father. Two psychological experts provided diametrically opposed opinions about the reliability of her statements. One expert, a clinician, opined that the girl's statements were based on autosuggestion whereas the other expert, a memory researcher, stated that autosuggestion was unlikely to have played a role. This case and the analysis of the experts' opinions illustrate what may happen when experts in court are unaware of the recent literature on (false) memory. That is, recent studies show that autosuggestion is less likely to occur in young children than in older children and adults. The current case stresses the importance and implications of relying on memory experts in cases concerning the reliability of eyewitness statements.     

Wrist slashing in a detention center. Case report and review of the literature

Suicides that occur in custody are rare and thus require extensive forensic analysis. Asphyxia by hanging is the most common means of suicide: at least 87.5% of successful suicides are committed in this way. A unique case of suicide in custody is presented in which a prisoner slashed his wrist with an eyeglass lens. The evidence and proceedings that led to this suicide are reviewed and the data are compared with known behavioral patterns. The world literature concerning suicide while incarcerated is reviewed.     

Fatal brown bear (Ursus arctos) attack: case report and literature review

Bear incidents are widely publicized, though serious incidents rarely occur. We describe here a case of human death caused by brown bear (Ursus arctos) feet. The brown bear is the biggest carnivore of Greece, reaching up to 200-300 kg weight.This is the first documented fatality involving a brown bear in Greece in which the victim died as a direct traumatic result of the attack.     

Human Trafficking and Slavery in Australia: Pathways,Tactics, and Subtle Elements of Enslavement

Human trafficking and slavery are heinous crimes that occur in all regions of the world. Victims are frequently trafficked or enslaved using tactics involving force, threats, or coercion. Perceptions of human trafficking and slavery often involve images of slaves, bound and shackled, kidnapped, and raped. Anecdotal evidence from Australia suggests that victims of human trafficking and slavery in Australia do not fit this stereotypical image. This article sets out to explore the more subtle elements of human trafficking and slavery in Australia through a review of human trafficking and slavery court case reports. The article presents summaries of case reports for the period 2004–2014 and identifies tactics of enslavement and pathways into slavery. The article also considers the implications—for identifying victims and combating human trafficking—of the more subtle methods of enslavement that occur in Australia.     

Environmental regulation, cost-benefit analysis, and the discounting of human lives

The loss of human life resulting from environmental contaminants generally does not occur contemporaneously with the exposure to those contaminants. Some environmental problems produce harms with a latency period whereas others affect future generations. One of the most vexing questions raised by the cost-benefit analysis of environmental regulation is whether discounting, to reflect the passage of time between the exposure and the harm, is appropriate in these two scenarios. The valuations of human life used in regulatory analyses are from threats of instantaneous death in workplace settings. Discounting, to reflect that in the case of latent harms the years lost occur later in a person's lifetime, is appropriate in these circumstances. Upward adjustments of the value of life need to be undertaken, however, to account for the dread and involuntary nature of environmental carcinogens as well as for higher income levels of the victims. By not performing these adjustments, the regulatory process may be undervaluing lives by as much as a factor of six. In contrast, in the case of harms to future generations, discounting is ethically unjustified. It is simply a means of privileging the interests of the current generation. Discounting raises analytically distinct issues in the cases of latent harms and harms to future generations. In the case of latent harms, one needs to make intra-personal, intertemporal comparisons of utility, whereas in the case of harms to future generations one needs to define a metric against which to compare the utilities of individuals living in different generations. Thus, the appropriateness of discounting should be resolved differently in the two contexts.     

An Unusual Case of Multiple‐Gunshot Suicide of an Alcohol‐Intoxicated Cancer Sufferer with Prolonged Physical Activity

Multishot firearm suicides are relatively rare and suggest the possibility of homicide. Physical activity following gunshots to the head, the neck, and the thorax does occur, and immediate incapacitation does not occur in every fatal gunshot wound that penetrates the head or perforates the heart. Cancer patients appear to be at increased suicide risk, but alcohol intoxication is less common in such cases. We present—to the best of our knowledge for the first time—a case of a 54‐year old, male, liver cancer sufferer, who under the influence of alcohol, discharged his revolver three times, suffered, among other wounds, a heart‐perforating wound, and died after c. 1.5 h, being able to talk until just before he died. Our case underlines the importance of keeping an open critical mind when dealing with multiple‐gunshot fatalities, especially when posttraumatic physical activity might be crucial in differentiating homicide from suicide.     

Further observations on the speed of death in hanging

Given that most fatal hangings are suicidal and occur in locations that have been selected to conceal this activity (thus maximizing the chances of a lethal outcome), there has been very little corroboration of the speed with which unconsciousness and death may occur. A 35-year-old male is reported who committed suicide by hanging immediately after talking to his spouse. Police investigations confirmed her reliability as a witness indicating that lethal anoxia in this case had occurred within a very short time (most likely in less than 1 min) of suspension. The speed with which death may result from hanging not only gives an insight into fatal pathophysiological mechanisms, but also provides useful information for situations where a lethal outcome is to be avoided, or is not intended. For example, individuals at risk of suicide who are being monitored in institutional facilities need to be constantly under direct visual surveillance as significant hypoxia can be rapidly induced, parents and caregivers with infants and children in potentially unsafe sleeping environments need to realize how swiftly death or irreversible anoxic brain damage may occur from neck compression, and those who engage in recreational asphyxia should be informed just how quickly a fatal outcome may ensue.     

Sudden death due to atlantoaxial subluxation in marfan syndrome

Marfan syndrome is 1 of the commonest inherited connective tissue disorders. Sudden death may occur and is usually attributed to cardiovascular manifestations of the syndrome. Atlantoaxial hypermobility, increased odontoid height, and rotatory subluxation are well described in this syndrome, but this paper details what seems to be the first reported case of sudden and unexpected death due to spontaneous atlantoaxial subluxation in Marfan syndrome.     

Fatal Clostridium perfringens Septicemia After Colonoscopic Polypectomy,Without Bowel Perforation

Since its introduction, colonoscopy has played an important role as a diagnostic, therapeutic, and screening tool. In general, colonoscopy is regarded as a safe procedure, but complications may occur. The most dreaded of these complications is colonic perforation. Bacteremia postprocedure may occur, and although it is not uncommon, it rarely results in clinically significant complications. Patients with IBD (inflammatory bowel disease) are a high‐risk population for bacteremia, which may leads to bowel wall overstepping by the bacteria. With regard to that, we report a fatal case of gas gangrene complicating colonoscopy polypectomy without bowel perforation in a healthy adult. To the best of our knowledge, only two other cases of retroperitoneal gas gangrene associated with colonoscopy polypectomy without bowel perforation have been described in international literature, but none of which was completed by a molecular biology analysis.     

A female mass murder

A case study of a 44-year-old woman who committed a mass murder is presented. Following a chronic course of psychotic deterioration, and a likely diagnosis of paranoid schizophrenia that remained untreated, she returned to her workplace after 3 years from her termination and killed seven people and herself. Her history is reconstructed through investigation of primary and secondary source materials. Although there are very few female mass murderers in recorded criminal history, this case is quite similar to the known research on mass murderers in general. Such individuals often have a psychotic disorder evident in violent and paranoid delusions, show a deteriorating life course before the mass murder, intentionally plan and prepare for their assault, and methodically kill as many individuals as possible before taking their own lives. They typically do not directly threaten the target beforehand, but do leak their intent to third parties--however, in this case, leakage and other obvious warning behaviors did not occur. Such acts are impossible to predict but depend on threat management and target security for risk mitigation.