法医病理检案工作中的人为现象

目的 研究法医病理检案工作中常见的人为现象及其造成法医学鉴定结论错误的原因。方法 收集13例法医病理复核鉴定案例,并对其进行回顾性分析。结果 胸外心脏按压所致肋骨骨折,胸、腹腔出血及肺动脉栓塞栓子破碎,误认为生前外伤或死因不明5例;胰腺死后变化(自溶和被膜下及间质出血),误认为急性出血坏死性胰腺炎4例;死后动物咬伤误认为生前损伤2例;腐败尸斑误认为皮下出血1例;死后颈部解剖不当造成颈部肌肉出血,影响死因分析1例。结论 法医病理检案工作中的人为现象,常导致法医学鉴定的结论错误。

Artifacts for mis-diagnosis in forensic pathological expertise

Objective To study the artifacts and differential key points in forensic pathology. Methods 13 cases, diagnosed as from other cause for death in medicolegal autopsies by forensic pathologists were again checked and analyzed. Results 5 of them, erroneousy diagnosed as antemortem injury or with cause of death undetermined, were actually caused by close chest cardiac compression, inducing fracture of ribs, hemorrhage of thoracic or abdominal cavity and embolusclasis of pulmonary embolism, respectively. 4 diagnosis as acute hemorrhagic necrotic pancreatitis, which were in fact caused by ensuing pancreatic autoly-sis and interstitial hemorrhage. 2 cases of animal bites after death were identified as antemortem injury. 1 case of cadaveric lividit was erroneously identified as subcutaneous hemorrhage. Another 1 case identified as cervical subcvtaneous hemorrhage, which was defacto caused by uncorrected neck autopsy after death. Conclusion Various artifacts often occur in forensic pathology. If care were taken of artifacts and their differentiation judged from antemortem injuries or pathological changes, could the erroneous diagnosis be avoided.