胃内容物推断死亡时间误差分析(附1例报告)

常女 ,7岁。 1 997年 3月 1 5日下午 6时左右失踪 ,次日发现被人抛尸于村外河沟内。尸检见常女发育正常 ,营养中等 ,尸斑不明显 ,尸僵存在于全身各处 ,较强硬。颈部有一索沟 ,有表皮剥脱及点状皮肤出血。颜面部青紫 ,口鼻有血性液体 ,口唇粘膜有点状出血。双眼球睑结膜有点状出血。处女膜完整 ,小阴唇内侧面有点片状膜内出血。解剖见颈部皮下及肌肉无明显出血 ,心脏浆膜面有点状出血 ,内部窒息征象明显。胃基本呈充盈状态 ,胃内容物呈半糊状 ,重约 30 0 ｇ ,其内容物可分辨出有梨皮、菠菜、大米、面疙瘩、粉条等。根据胃内容的量及消化程度…     

扼颈引起吸入性窒息死亡1例

案例:张某,女,17岁,被人害于玉米地里.尸检见头无损伤,眼睑结膜有点状出血,颈部左侧有横向不规则表皮剥脱伴皮下出血,处女膜3,6点处新鲜破裂.解剖见:颈部左胸锁乳突肌有不规则条片状出血斑,左胸骨舌骨肌舌骨端有绿豆大出血斑.舌骨无骨折,胸膜壁层点状出血,心外膜点状出血,气管及支气管内有多量胃内容物,其中明显可见青菜叶片等食物残渣;肺淤血水肿,表面有散在点状出血,切面有多量泡沫样粉红色液体流出.小支气管内容物涂片淀粉反应阳性.阴道拭子镜下检见人精子.胃内容物经化验未检出一般常见毒物.     

扼颈引起吸入性窒息死亡1例

案例:张某,女,17岁,被人害于玉米地里。尸检见头无损伤,眼睑结膜有点状出血,颈部左侧有横向不规则表皮剥脱伴皮下出血,处女膜3,6点处新鲜破裂。解剖见:颈部左胸锁乳突肌有不规则条片状出血斑,左胸骨舌骨肌舌骨端有绿豆大出血斑。舌骨无骨折,胸膜壁层点状出血,心外膜点状出血,气管及支气管内有多量胃内容物,其中明显可见青菜叶片等食物残渣;肺淤血水肿,表面有散在点状出血,切面有多量泡沫样粉红色液体流出。小支气管内容物涂片淀粉反应阳性。阴道拭子镜下检见人精子。胃内容物经化验未检出一般常见毒物。1.扼死是指用一只手或双手压迫受害人…     

灌食米糊致吸入性窒息死亡1例

1案例资料 1.1 简要案情 某女,45岁.因囚禁绝食3d被人灌食米糊后,出现咳嗽、烦躁、口唇发绀、昏迷等症状,经送医院抢救无效于当日下午6时许死亡. 1.2尸体检验 死后1d解剖.尸斑暗红色,全身体表无损伤,颜面部肿胀,口唇及双手指甲发绀,双眼睑结膜见出血点,左眼球结膜内侧见芝麻大小片状出血.颈部肌肉无损伤,舌骨及甲状软骨无骨折,局部软组织无出血.口腔、咽、喉部见少量乳白色米糊样物质附着,气管及左、右支气管腔内见米糊状物,食道内干净,胃呈空虚状;脑、心、肝、肾等肉眼观无异常.     

机械性窒息与氰化物中毒并存的尸检分析1例

1案件简介某年11月26日下午,某山庄一别墅内发现女户主易某及余某在家中死亡,易某呈仰卧位倒在客厅沙发边地上,余某的尸体位于本人卧室床上,呈仰卧位,身上盖有棉被。易某（女）尸检情况：尸斑呈暗紫红色,位于项部、背部及四肢背侧未受压处,指压褪色。左眼睑结膜苍白,左眼球穹隆部见小点状出血,右眼上睑结膜外侧见小点状出血,右眼下睑、球结膜苍白。口鼻周围红肿,上、下唇见散在的小片状表皮剥脱,口唇粘膜与皮肤交界处呈鲜红色,下唇粘膜正中见点状出血区;头颅解剖无异常。剖开颈部、胸腹部,见死者血液呈流动性,颈部皮下及肌肉无出血,舌骨及甲状软骨无骨折。气管内见大量白色泡沫,气管粘膜无充血水肿;     

霰弹贯通喉部致声门水肿窒息死亡1例

1案例1997年9月30日,王某与李某（男,29岁）外出打猎,途中王某的猎枪走火,击中了李某,lh后,李某在被送往医院途中死亡。尸检见尸体头左颞顶部、左面颊部、左侧颈部及左肩部散在分布30余处小孔状创口,直径25～30cm。喉结下1．5cm处、前正中线左右两侧各有一直径约1．5mm的小孔状创口,两创相距2．0cm,两创连线呈水平位。打开胸腔,见双肺呈淤血性肺水肿,浆膜下散在分布有点片状出血;心脏浆膜下散在分布有针尖状出血点。打开喉部及气管,见声带充血水肿,声门高度狭窄呈闭锁状。左右甲状软骨板分别有一直径约1．5mm的穿孔,与体表喉…     

压颈窒息合并钝性外力致心脏破裂死亡1例

压颈窒息致人死亡在法医实践中时有所见,但同时合并钝性外力作用于胸部造成心脏破裂比较少见。现将笔者所遇1例报告如下: 1995年3月18日下午胡某死于自己家中,家人怀疑他杀而报案。 死后24小时尸检:尸长156cm,尸斑紫褐色位于背部未受压处,指压不褪色。面部青紫肿胀,双眼睑结膜有点片状出血,双侧瞳孔等大等圆,直径0.6cm。鼻腔中有胃内容溢出。口唇青紫,口腔内充满胃内容物。颏下区有6cm×3.5cm擦挫伤,左下颌角有5cm×4cm片状擦伤,颈前有一10cm×6cm紫红色挫伤。肛门大便溢出,阴茎龟头有精液溢出,其它部位未见明显损伤。解剖见:     

三起毒鼠强中毒案的法医学分析

<正> 1案例资料 案例1 某男,51岁。进食早餐后不到10min,自觉不适,突然晕倒、抽搐、痰中带血,半小时内死亡。 尸检见尸斑呈暗红色,尸僵极其强硬,四肢呈痉挛状态;口唇、甲床紫绀;全身血管充盈,血液呈流动性;气管内见淡红色泡沫状液体,肺淤血、水肿,肺叶间胸膜见点片状出血;胃内容物为浅褐色水样物,胃粘膜充血水肿,胃大弯部见粘膜片状脱落;肝赃、肾脏淤血。余无特殊。     

华-佛氏综合征猝死3例分析

华-佛氏综合征(Waterhouse-Friederichsen＇s syn-drome)为暴发性流行性脑脊髓膜炎的一种类型,五、六十年代较常见,随着医疗条件的进步,目前在法医工作中并不多见,现将笔者所遇3例结合文献报道如下.1 案例资料例1 黄某,男,7个月.1999年2月25日零时许,黄因出现发热,到一诊所就医,诊断为“感冒”,给予柴胡、地塞米松等药物治疗.用药后无明显好转,当日上午10时其父母发现黄全身出现紫黑色的出血点,仍发热,精神极差,急送某大医院,经抢救无效于上午11时40分死亡.尸检见颈部、胸腹部及双下肢有点状出血点.脑重950克g,脑膜血管淤血明显,脑水肿;镜下蛛网膜内及其下有以中性白细胞为主的炎性细胞浸润或渗出(图1).肾上腺呈暗红色,切面明显出血;镜下肾上腺皮质、髓质出血,以髓质明显,部分区域正常结构消失,皮质细胞脂质脱失.其它脏器未见明显病变.尸检诊断:华-佛氏综合征.     

吞针后勒颈自杀法医学分析1例

<正>1案例资料1.1简要案情及现场勘验包某,女,43岁,某日被发现死于家中床上。尸体呈仰卧位,头及肩背部枕于两只枕头上,颈部紧勒一棕色牛皮带,搭扣位于右项部,皮带自左向右扭曲折叠后穿过搭扣并向左颈部反折,顺时针扭曲沿腋前线下行握于左手,穿出左手部分长30cm,双上肢自然屈曲于胸腹前。赤足,足内侧弓及其上方有点状血迹,足底有泥。头部南侧枕头边缘及床头、床边有血迹,床头边垃圾篓内见红色血液约4m L,垃圾篓南侧     

Sex determination from os sacrum by postmortem CT

Sex determination in forensic practice is performed mostly on sexually dimorphic bones, including pelvic bones such as the os sacrum. Postmortem CT scan provides an easy and fast method for depicting and measuring bone structures prior to elaborate autopsy preparations. To develop a simple and objective method for sex determination in postmortem CT, metric data were evaluated from CT images of the pelvic-associated os sacrum of 95 corpses (49 men and 46 women) from the Canton of Bern, Switzerland. Discriminant function analysis of the data showed that the best accuracy in determining sex was 76.8% and 78.9% with two different observers. It is concluded that measuring the os sacrumin postmortem CT for sex determination has moderate accuracy and should only be applied in combination with other methods.     

Disposition of citalopram in biological specimens from postmortem cases

Citalopram is a bicyclic phthalate compound approved in 1998 by the U.S. Food and Drug Administration for the treatment of depression. It is a highly selective serotonin reuptake inhibitor that appears to have little effect on noradrenaline or dopamine reuptake. Since this drug has only recently been released on the U.S. market, information regarding therapeutic, toxic, and lethal concentrations is sparse. This study reports the detection of citalopram in 22 postmortem cases. Citalopram was identified and quantitated by capillary column gas chromatography with nitrogen phosphorus detection after basic liquid-liquid extraction. Confirmation was achieved by full scan electron impact gas chromatography/mass spectrometry. In the 22 cases studied, heart blood citalopram concentrations ranged from 0.09 to 1.64 mg/L (n = 22, mean +/- SD = 0.51+/-0.43, median = 0.34); femoral blood concentrations ranged from 0.09 to 0.76 mg/L (n = 14, mean +/- SD = 0.34+/-0.23, median = 0.28); and urine concentrations ranged from 0.05 to 276.00 mg/L (n = 13). Liver was analyzed in three cases with citalopram concentrations ranging from 2.22 to 8.08 mg/kg. The average heart blood/femoral blood ratio was 1.26 (range 0.75 to 1.98, n = 14). In each case, the cause of death was not considered to be related to citalopram toxicity. These data may therefore provide a basis for establishing post mortem citalopram concentrations following therapeutic doses.     

Distinguishing antemortem from postmortem injuries by LTB4 quantification

Leukotriene B₄ (LTB₄) in skin samples from seven forensic cases was detected by HPLC to distinguish their antemortem or postmortem origin. In total, there were thirteen antemortem and seven postmortem specimens. The results showed that LTB₄ was found in all antemortem wound specimens which were either fresh, or refrigerated or fixed in formalin for less than 10 days. In contrast, LTB₄ could not be detected in postmortem wound specimens. These results suggested that detecting the content of LTB₄ is a useful method for distinguishing antemortem from postmortem injuries.     

Disposition of quetiapine in biological specimens from postmortem cases

Quetiapine is a new atypical antipsychotic that was approved in 1997 by the U.S. Food and Drug Administration for the treatment of schizophrenia. It possesses a high affinity for 5-HT2 receptors and a low affinity for D1 and D2 dopamine receptors. Because quetiapine has only been released recently to the U.S. market, little information exists regarding therapeutic, toxic, and lethal concentrations. This study reports the detection of quetiapine in 13 postmortem cases. Following a basic liquid-liquid extraction, quetiapine was identified and quantitated by capillary gas chromatography with nitrogen phosphorus detection. Confirmation was accomplished by full scan electron impact gas chromatography/mass spectrometry. Heart blood quetiapine concentrations ranged from 0.07 to 18.37 mg/L (N = 12, mean +/- SD = 3.42 +/- 5.67, median 0.62) and femoral blood concentrations ranged from 0.06 to 19.25 mg/L (N = 10. mean +/- SD = 3.89 +/- 6.12, median 0.81). The average heart blood/femoral blood ratio was 1.31 (range 0.55 to 2.57, N = 10). Urine, bile, and gastric contents were assayed in all cases in which they were submitted. In three cases, the cause of death was determined to be quetiapine toxicity. In these cases heart blood concentrations ranged from 0.72 to 18.37 mg/L (N = 3). These data may provide a basis for establishing levels associated with quetiapine toxicity as well as therapeutic concentrations in postmortem specimens.     

Quantitative and qualitative analysis of DNA extracted from postmortem muscle tissues

DNA extracted from 33 postmortem muscle specimens was analyzed using MZ 1.3, a hypervariable minisatellite probe, as well as locus-specific minisatellite probes (g3, MS1 and MS43). After storage at -25 degrees C for 10 months, DNA from all the samples was partially (approximately 21% of total DNA) degraded even when autopsy was performed 1 day postmortem. However, more than 90% of DNA samples up to at least 3 days postmortem were suitable to obtain good restriction fragment length polymorphism (RFLP) patterns. When small strips of specimen were stored for 8 days at room temperature in moist chambers, approximately 42% of total DNA was degraded. Only 30% of these DNA samples still showed good RFLP patterns. However, no obvious relation between qualities of DNA analyzed by detection of RFLP and quantities of total and high-MW DNA became apparent. A case of familial relationship was ascertained by DNA fingerprints. Since DNA of good quality can be recovered from muscle tissues in large quantities, DNA extraction from muscle tissues and detection of RFLP patterns should be very useful for individual identification in autopsy cases.     

Minimally invasive postmortem telebiopsy

For the past 10 years, medical imaging techniques have been increasingly applied to forensic investigations. To obtain histological and toxicological information, tissue and liquid samples are required. In this article, we describe the development of a low-cost, secure, and reliable approach for a telematic add-on for remotely planning biopsies on the Virtobot robotic system. Data sets are encrypted and submitted over the Internet. A plugin for the OsiriX medical image viewer allows for remote planning of needle trajectories that are used for needle placement. The application of teleradiological methods to image-guided biopsy in the forensic setting has the potential to reduce costs and, in conjunction with a mobile computer tomographic scanner, allows for tissue sampling in a mass casualty situation involving nuclear, biological, or chemical agents, in a manner that minimizes the risk to involved staff.     

Human pentastomiasis discovered postmortem

The autopsy of an 18-year-old girl who had died suddenly at home revealed generalised pentastomiasis. The location of this disease in the intestines was responsible for death by hemorrhagic enterocolitis. This discovery constituted an atypical case in our daily practice of forensic medicine.