Fatal postpartum spontaneous liver rupture: case report and literature review

Maternal hepatic rupture is a rare complication of pregnancy that can be fatal to both mother and child. This phenomenon is most often associated with preeclampsia/eclampsia and/or HELLP syndrome, which is defined by a collection of clinical features including hemolysis (H), elevated liver enzymes (EL), and a low platelet count (LP). These disease processes are typically identified and treated during pregnancy, often in the last trimester. The described case is unusual in that the decedent had no known history of preeclampsia/eclampsia or HELLP syndrome during this pregnancy, and she died suddenly several days postpartum of liver rupture with massive intraperitoneal hemorrhage following a routine cesarean section delivery and an uneventful hospital course. Similar cases are infrequent in the literature, which is reviewed in this report.     

头颈外伤致椎动脉破裂伴颅底蛛网膜下腔出血1例尸检分析

头颈外伤致椎动脉破裂伴颅底蛛网膜下腔出血１例尸检分析易旭夫，刘敏，吴家Ｓｕｂａｒａｃｈｎｏｉｄｈａｅｍｏｒｒｈａｇｅｄｕｅｔｏｒｕｐｔｕｒｅｏｆｔｈｅｖｅｒｔｅｂｒａｌａｒｔｅｒｙａｓｓｏｃｉａｔｅｄｗｉｔｈｈｅａｄｔｒａｕｍａ：ｒｅｐｏｒｔｏｆｏｎ...     

Death associated with nitrite ingestion: report of a case

The tissue concentrations of nitrite and nitrate found at autopsy of a case of intentional ingestion of nitrite salts have been reported. The percentage of methemoglobin and the serum nitrite concentrations are consistent with those reported for acute overdoses. We conclude that noth nitrite and nitrate salts may be identified in tissues from persons ingesting only nitrite salts and that a significant conversion to nitrate may result from oxidation of nitrite during the conversion of heme iron to Fe3+.     

Death associated with fluorocarbon inhalation: report of a case.

This case documents postmortem tissue concentrations of fluorocarbons in an individual whose inhalation of cooking spray vapors was well documented. The data presented here should contribute to the information base which will assist the pathologist in determining the cause of death in cases related to inhalation of these fluorocarbons.     

Spontaneous rupture of the oesophagus

A case of death due to spontaneous rupture of the oesophagus is reported. Few similar cases have been previously reported. In some the oesophageal wall had been weakened by previous ulceration or scarring. In this case there was no history or postmortem evidence of such damage. Under certain circumstances postmortem rupture of the oesophagus could occur and should be distinguished from antemortem rupture.     

Spontaneous rupture of the urinary bladder

The report presents the case of a 33-year-old man under the primary assumption of homicide in which the court-ordered autopsy revealed death as a result of bleeding due to a spontaneous rupture of the urinary bladder. The article gives a short summary of the pathomorphological findings and their respective causes, for example the typical location of the rupture at the posterior wall and roof of the bladder and the common concomitant drunkenness. Furthermore, obligatory forensic investigations--beside the autopsy--are mentioned and discussed.     

Environmental conditions associated with shark attacks against humans: a case report about territoriality

This article describes the autopsy findings of a victim of a shark attack that took place off the coast of Pernambuco, Brazil. The victim was rescued and immediately taken to a nearby hospital but did not survive, even though the lapse of time between the attack and verification of death did not exceed 15 minutes. The presence of a single, large, contused and incised, semiarched wound with a serrated aspect was decisive in elucidating the event. Thus, this study discusses aspects related to the aggressor species, to the autopsy, to the type of wound, and to the causes that have led to a significant increase in this type of event in the area. It was concluded that the lesion was produced while the victim was still alive and that it was the cause of death.     

Fracture of the hyoid bone associated with atlantoaxial subluxation: a case report and review of the literature

Hyoid bone fractures secondary to blunt trauma other than strangulation are rare. Only 27 cases have been reported in the literature. They have few, if any, complications, such as dysphagia, hypoxia, cardiorespiratory collapse, laceration of the pharynx, mandibular fracture, thyroid cartilage fracture, and facial fracture. No report of hyoid bone fracture associated with spinal column injury was reported in the English literature. The authors reported a 46-year-old male patient who complained of neck pain and odynophagia after a traffic accident. After systemic examination and cervical CT scan, the diagnosis of hyoid bone fracture at the right great horn and atlantoaxial subluxation was made. The patient was observed in ICU for 48 hours. A nasogastric tube was inserted for feeding. Fifteen milligrams of dexamethasone was given once a day for 3 days to reduce the swelling and pain. We performed a cutaneous traction for the subluxation and carefully watched the hyoid bone and the patient's respiration. No lethal complications occurred. Two weeks later, the patient was allowed to ambulate with cervical collar protection and to resume oral intake. Three months later, he was asymptomatic. This case, with hyoid fracture and atlantoaxial subluxation, is the only case reported in the literature. The importance of hyoid fracture, however, rests not with the rarity of it, but with the lethal potential of missing diagnosis. Nonsurgical management may be effective in most of the cases.     

腹部闭合性损伤胰腺断裂1例

胰腺属腹膜后器官,受到较好的保护.在腹部损伤尤其是腹部的闭合性损伤中,胰腺的损伤较为罕见.据文献报道,胰腺损伤仅占腹部闭合性损伤的1%～2%.现报告1例.     

腹部闭合性损伤胰腺断裂1例

胰腺属腹膜后器官,受到较好的保护。在腹部损伤尤其是腹部的闭合性损伤中,胰腺的损伤较为罕见。据文献报道,胰腺损伤仅占腹部闭合性损伤的1%～2%。现报告1例。案例林某,男,21岁,漳州市芗城人。2004年10月31日21时左右,林驾驶二轮摩托车左转时与一辆直行的货车碰撞发生交通事故,     

Fatal splenic rupture following Heimlich maneuver: case report and literature review

The most effective resuscitative procedure in choking by foreign bodies is the Heimlich maneuver, described for the first time by Henry Heimlich (1974) and recognized by the US Surgeon General (1985) as the "only method that should be used for the treatment of choking from foreign body airway obstruction." If performed correctly, this lifesaving maneuver is associated with rare complications, of which the most frequent are rib fractures and gastric or esophagus perforations. Other rare traumatic injuries such as pneumomediastinum, aortic valve cusp rupture, diaphragmatic herniation, jejunum perforation, hepatic rupture, or mesenteric laceration have been described.However, we are unaware of previous reports of splenic rupture after Heimlich maneuver. We present an interesting case of fatal hemoperitoneum due to a hilar laceration of the spleen following a correctly performed Heimlich maneuver.     

Traumatic rupture of the anterior papillary muscle. Review of the literature and report of a case

A case of traumatic rupture of the anterior papillary muscle is presented. The patient survived for 3.5 h after injury without showing any serious cardiac symptoms, and in the absence of external chest injuries. Cardiac injury should always be suspected after a head-on collision, even if significant symptoms are missing.     

Spontaneous rupture of unscarred gravid uterus

Rupture of gravid uterus during pregnancy is a rare entity. Overall incidence of rupture of uterus during pregnancy is 0.07%. The maternal and fetal prognoses are bad especially when the rupture occurs in an unscarred uterus. Fortunately, the sole major risk factor of spontaneous rupture of unscarred uterus is preventable, which is "multiparity." In this article, we report the death of a pregnant woman and her unborn child because of spontaneous rupture of unscarred uterus.     

外伤致乳房假体破裂的法医学鉴定(附1例报道)

随着我国社会经济的发展 ,人们的生活质量不断提高 ,女性对自己形象要求更加完美。乳房作为女性的重要性征 ,其形态和大小更加受到重视。应用置入假体的隆乳术 ,可使乳房发育不良的妇女达到丰乳的目的 ,使她们的美好愿望成为实现 ,加上隆乳技术及填充材料的改进 ,目前女性实施隆乳手术的人数逐年增加。伴随因隆乳带来的医疗纠纷也时有发生 ,相关文献上屡见报道。但在法医学鉴定中 ,外伤造成胸部损伤合并乳房假体破裂的鉴定尚未见到 ,由于此类案件在鉴定过程中 ,缺乏相应依据条款 ,增加了鉴定难度。本文结合 1例胸部损伤合并乳房假体破裂案 ,…