Unusual breast findings in a transsexual

A case is reported of the death, following a drug overdose, of a 52-year-old transsexual who had injected paraffin wax into his chest in order to enlarge his breasts many years earlier. This had resulted in subsequent development of chronic abscess and sinus formation. Histological examination showed no evidence of hormone-induced gynecomastia, but instead showed long-standing inflammatory changes with bone formation in the subcutaneous tissue.     

Suicide by fire in a car trunk: a case with potential pitfalls

We present an unusual case in which an adult female committed suicide by fire while enclosed in the trunk of her vehicle. A finding of suicide was reached only because several key investigative facts were uncovered. Without these discoveries the case may still remain open as a suspicious death. Fire is rarely used as a mechanism of suicide in Western culture, and, as such, similar cases should be reported to advance our recognition of this phenomenon.     

Postmortem non-invasive virtual autopsy: death by hanging in a car

A body was found behind a car with a noose tied around its neck, the other end of the rope tied to a tree. Apparently the man committed suicide by driving away with the noose tied around his neck and was dragged out of the car through the open hatchback. postmortem multislice-computed tomography (MSCT) and magnetic resonance imaging (MRI) indicated that the cause of death was cerebral hypoxia due to classic strangulation by hanging, and not due to a brainstem lesion because of a hang-man fracture as would be expected in such a dynamic situation. Furthermore, the MRI displayed intramuscular haemorrhage, bleeding into the clavicular insertions of the sternocleidomastoid muscles and subcutaneous neck tissue. We conclude that MSCT and MRI are useful instruments with an increased value compared with 2D radiographs to augment the external findings of bodies when an autopsy is refused. But further postmortem research and comparing validation is needed.     

Unusual neck lesion in a pedestrian caused by a road accident

The authors describe a road accident that occurred in the Trieste region of Italy in 1998, wherein a pedestrian experienced a mortal injury. During the on-site examination, the forensic officer in charge noticed, in addition to dispersed abrasions, bruises, and fractures, an unusual position of the head with a highly unusual motility of the cervical rachis and, above all, an apparent whitish fibrous elastic cord, 7-8 cm long, which came out of the mouth. The cord was found to be a segment of the spinal cord, expelled and driven into the mouth cavity by the impact. This represents an interesting case because of the specific dynamics of the accident and the type of lesion involved. This kind of spinal cord injury, in particular, is infrequent among pedestrians involved in road accidents in comparison with other road casualties.     

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.     

Unusual injuries caused by blows with a sash saw

A 62-year old man was found killed by multiple blows against the face and head; near the victim a hammer with broken grip, a bended saw (weight 142 g), and in the possession of the doer two hatchets. Some straigt, parallel, horizontal wounds in the face with smooth lips and straigt incisions of the maxilla first were interpreted as violations by hatchet. The culprit confessed attacks by hammer and saw, but not by hatchet. Experimental blows with a saw like the used on the leg of a corpse showed an unexpected result: it was possible to produce wounds of the soft-tissues and the bone similar to those by hatchets.     

Unusual death of a farmer.

A farmer was found dead, in a pool of blood on his farm. Evidence indicated that the farmer had dragged himself or been dragged from the stable to the point where his body was found. With the exception of abrasions in the face, there were no other signs of injury. An autopsy revealed a depressed fracture of the skull and showed a venous air embolism to be the cause of death. The medicolegal interpretation of the findings left no doubt that the farmer was killed by a cow.     

特殊火场尸体检验体会1例

在法医命案现场勘验中,火场尸体案件并不鲜见。犯罪嫌疑人为了达到毁灭罪证、逃避打击的目的,可能会选择纵火焚烧现场,处于现场中的人体亦     

Pulmonary embolization by chorionic villi causing maternal death after a car crash

Throughout the last century, there has been a marked decline in obstetric maternal deaths, resulting in an increase in the proportion of nonobstetric deaths among pregnant women. Trauma, in particular, has become a leading cause of maternal death. We report the case of a 20-year-old primigravid woman who was involved in a motor vehicle crash at 36 weeks gestation. The woman developed abruptio placentae, followed by disseminated intravascular coagulation, adult respiratory distress syndrome, and shock, and died the day after the crash. Widespread pulmonary embolization by chorionic villi was identified at autopsy. This report discusses traumatic maternal deaths, with emphasis on the differences in injury pattern observed in pregnant trauma victims in comparison with other adults. It is important that the pathologist be aware of these problems so that an accurate cause of death can be identified in cases of maternal death after trauma. Also discussed is the relationship between trauma and placental abruption and the mechanism of death in the patient. To the authors' knowledge, this is the first reported case of extensive embolism of chorionic villi to the lungs after trauma.     

特殊火场尸体检验体会1例

在法医命案现场勘验中,火场尸体案件并不鲜见。犯罪嫌疑人为了达到毁灭罪证、逃避打击的目的，可能会选择纵火焚烧现场。处于现场中的人体亦常常被烧毁。典型的焚尸命案相对容易甄别,而一些比较特殊的案例，检验和甄别的难度较大,尸检过程中容易出现疏漏或者误判。本文就实际检案工作中遇到的一起案例进行报告。     

Unusual motor ability in gunshot injury of the heart caused by a shotgun

In a case of shotgun-injury of the heart with complete rupture of both ventricles and lesion of the aorta the victim was able to move a few metres in approximately six seconds. Despite other opinions ability to move or act can be maintained in cases of severest injuries of the heart caused by missiles with high energy.     

Wrapped to death. Unusual autoerotic death

Despite the large population of New Orleans, including many homosexual and transsexuals, there have been relatively few cases of autoerotic deaths. The case reported here is an interesting one as it includes a bizarre form of autoerotic behavior from the standpoint of the method used. There have been no deaths reported in the literature in which the victim died as a result of jeopardizing himself by enclosing his body into plastic with an airway out of his "cocoon" in the form of a snorkel tube. He was engaged in masturbation when he apparently lost his mouth piece or airway. He attempted to use a knife to cut himself out.     

Sudden death caused by hydatid embolism

An 18-year-old man died on the spot during a foot race. Previously, he had been in a healthy condition. Since the cause of his sudden death was unknown, a forensic autopsy was carried out. The autopsy revealed hydatid cysts in the right ventricle of the heart some of which had embolized the pulmonary arteries. In case of sudden death in endemic areas the possibility of a hydatid disease should be taken into consideration.     

An unusual death caused by strangulation

An accidental case of strangulation is reported in which the victim caught his head in the gap of a wooden shed. Before passing into unconsciousness rescue was attempted.     

Unusual fatalities caused by glass splinter injury]

In the case of a thorax stab wound and an intrapulmonal position of the glass fragment (fall from a ladder into a glass door) an extrathoracic cardiac massage had been carried out. The result of which, an extremely unusual "reanimationtrauma" and the problems connected with it are discussed. In another case of a stab wound of the right iliacal vessels and the position of the glass fragment in the minor pelvis (jump through a thermopane glass of a door, followed by a fight) investigations were first conducted because of the suspicion of manslaughter. The autopsy, however, completely excluded death through fault of another. Further an unusual figured glass cut wound on the left side of the head (fall into a glass brick wall) led to death through gradual bleeding. The question arose whether death was caused by failure to give assistance.     

Investigation of a death caused by rectal insertion of cocaine

A 29-year-old homosexual man died as a result of cocaine inserted into his rectum by his sexual partner. The apparent purpose of this form of drug abuse is to relax the anal sphincter muscles. However, as in this case, cocaine administered in this fashion has a high potential for toxicity. The possible legal and medical ramifications of death resulting from this practice are discussed.     

Changes in skeletal muscles in death caused by hypothermia

The review of 32 deaths resulting from hypothermia yielded mostly the common pathological findings as bright red livores, haemolytic frost marks of the skin and Wichnewski erosions of the gastric mucosa. In addition the muscle system of the body core (musc. ileopsoas) showed hemorrhages and histologically necrosis of its fibres in form of segmental and discoid sarcoplasmatic alteration. These changes are a quite specific sign of death due to hypothermia, as far as mechanical injury can be excluded. For best result however a special autopsy technique and an appropriate histological staining are advisable.     

Sudden death caused by malignant testicular tumors

Sudden unexpected death of apparent healthy young males due to malignant tumours are extremely rare in forensic autopsy material. We report on three such cases dying of pulmonary embolism caused by metastazing tumour of the testis. In each subject the tumour was localized to the right testis and consisted of two types of tumour tissue: Seminoma and embryonic carcinoma, the latter of which was always the metastazing one. Each of the cases represent different aspects of forensic medicine. In the first subject the tumour had remained undiagnosed in a recent medical examination. The second one underwent surgery because of acute abdomen and died intraoperatively and the third one died suddenly during antibiotic treatment, because the tumour had been mistakenly diagnosed as orchitis.