Forensic pathology - Revision history

Michael: /* Death categorization */ fix word 'lightning'

2017-03-27T13:47:54Z

Death categorization: fix word 'lightning'

← Older revision		Revision as of 13:47, 27 March 2017
Line 15:		Line 15:
	\| accident		\| accident
	\| [[cardiac arrhythmia]]		\| [[cardiac arrhythmia]]
	\| man struck by ~~lightening~~		\| man struck by lightning
	\|-		\|-
	\| Hyperthermia		\| Hyperthermia

Michael: /* Ethylene glycol toxicity */

2016-04-23T20:36:19Z

Ethylene glycol toxicity

← Older revision		Revision as of 20:36, 23 April 2016
Line 835:		Line 835:
	:For a more general discussion see ''[[Crystals_in_body_fluids#Urine_crystals\|urine crystals]]''		:For a more general discussion see ''[[Crystals_in_body_fluids#Urine_crystals\|urine crystals]]''
	*Not done in routine toxicology screening.		*Not done in routine toxicology screening.
	*Birefringent calcium oxalate crystals found in kidney (with polarized light).<ref name=Ref_KFP589>{{Ref KFP\|589}}</ref>		*Birefringent calcium oxalate crystals found in kidney (with [[polarized light]]).<ref name=Ref_KFP589>{{Ref KFP\|589}}</ref>

	====Anaphylaxis====		====Anaphylaxis====

Tate: /* Aortic trauma */

2015-08-12T14:26:00Z

Aortic trauma

← Older revision		Revision as of 14:26, 12 August 2015
Line 540:		Line 540:

	===Aortic trauma===		===Aortic trauma===
	*Classic location of ~~injury~~ is subclavian branch point.<ref name=pmid1934437>{{cite journal \|author=Kodali S, Jamieson WR, Leia-Stephens M, Miyagishima RT, Janusz MT, Tyers GF \|title=Traumatic rupture of the thoracic aorta. A 20-year review: 1969-1989 \|journal=Circulation \|volume=84 \|issue=5 Suppl \|pages=III40–6 \|year=1991 \|month=November \|pmid=1934437 \|doi= \|url=}}</ref>		*Classic location of transection of the aorta is distal the the left subclavian branch point near the insertion of the ligamentum arteriosum (e.g. peri-isthmus).<ref name=pmid1934437>{{cite journal \|author=Kodali S, Jamieson WR, Leia-Stephens M, Miyagishima RT, Janusz MT, Tyers GF \|title=Traumatic rupture of the thoracic aorta. A 20-year review: 1969-1989 \|journal=Circulation \|volume=84 \|issue=5 Suppl \|pages=III40–6 \|year=1991 \|month=November \|pmid=1934437 \|doi= \|url=}}</ref>
	*[[Aortic dissection]] due to trauma is often catastrophic.		*[[Aortic dissection]] due to trauma is often catastrophic. Several mechanisms have been proposed and there is a body of trauma biomechanics research that explores this.

	==Trauma with delayed death==		==Trauma with delayed death==

Tate: /* Motor vehicle collisions */

2015-08-12T14:21:05Z

Motor vehicle collisions

← Older revision		Revision as of 14:21, 12 August 2015
Line 501:		Line 501:
	===Motor vehicle collisions===		===Motor vehicle collisions===
	*Pedestrian vs. motor vehicle: heel to injury measurement, remember to include the thickness of the heel/sole of shoe.<ref>{{Ref OPMfP\|18}}</ref>		*Pedestrian vs. motor vehicle: heel to injury measurement, remember to include the thickness of the heel/sole of shoe.<ref>{{Ref OPMfP\|18}}</ref>
			*Dicing injuries: tempered glass used in side window construction fragments into cubes when fractured causing L-shaped wounds.

	===Descent from height===		===Descent from height===

Tate: /* Motor vehicle collisions */

2015-08-12T14:19:10Z

Motor vehicle collisions

← Older revision		Revision as of 14:19, 12 August 2015
Line 500:		Line 500:
	==Scenarios==		==Scenarios==
	===Motor vehicle collisions===		===Motor vehicle collisions===
	*Pedestrian vs. motor vehicle: heel to injury measurement.<ref>{{Ref OPMfP\|18}}</ref>		*Pedestrian vs. motor vehicle: heel to injury measurement, remember to include the thickness of the heel/sole of shoe.<ref>{{Ref OPMfP\|18}}</ref>

	===Descent from height===		===Descent from height===

Michael: /* Word form for cause of death */

2015-05-30T14:09:48Z

Word form for cause of death

← Older revision		Revision as of 14:09, 30 May 2015
Line 78:		Line 78:

	====Word form for cause of death====		====Word form for cause of death====
	~~Example~~:		Examples:
	*''[[C. difficile colitis]] complicating antibiotic treatment for a dental abscess''.<ref>MSP. 8 September 2010.</ref>		*''[[C. difficile colitis]] complicating antibiotic treatment for a dental abscess''.<ref>MSP. 8 September 2010.</ref>
	*''Complications of laparoscopic cholecystectomy for ascending cholangitis with [[mesothelioma]] and atherosclerotic heart disease''.<ref>TR. 3 September 2010.</ref>		*''Complications of laparoscopic cholecystectomy for ascending cholangitis with [[mesothelioma]] and atherosclerotic heart disease''.<ref>TR. 3 September 2010.</ref>

Michael: /* Environmental */

2015-05-10T15:49:14Z

Environmental

← Older revision		Revision as of 15:49, 10 May 2015
Line 448:		Line 448:
	==Environmental==		==Environmental==
	{{Main\|Environmental causes of death}}		{{Main\|Environmental causes of death}}
			They include:
			*[[Hypothermia]].
			*[[Hyperthermia]].
			*Drowning - see [[asphyxial deaths]].
			*Lack of oxygen - see [[asphyxial deaths]].
			*[[Electrocution]].

	=Gunshot wounds=		=Gunshot wounds=

Michael: /* Environmental */ split out

2015-05-10T06:04:14Z

Environmental: split out

← Older revision		Revision as of 06:04, 10 May 2015
Line 447:		Line 447:

	==Environmental==		==Environmental==
	~~Includes:~~		{{Main\|Environmental causes of death}}
	*Hypothermia.
	*Hyperthermia.
	*Drowning - see [[asphyxial deaths]].
	*Lack of oxygen - see [[asphyxial deaths]].
	*Electrocution.

	~~===Hypothermia===~~
	~~Features:<ref name=>~~{{~~cite journal~~ \|author=E. E. Türk, J. P. Sperhake, K. Pueschel and Michael Tsokos \|title=An approach to the evaluation of fatal hypothermia \|journal=Forensic Science, Medicine, and Pathology \|volume=1 \|issue=1 \|pages=31–35 \|year=2005 \|month= \|pmid= \|doi= \|url=http://www.springerlink.com/content/n785314u75m71j8h/fulltext.pdf}}</ref>
	*Reddening of exposed skin areas "frost erythema" - '''classic feature'''.
	*Wischnewski spots ([[AKA]] Leopard spots) - '''classic feature'''.
	**Brown/black spots of the gastric mucosa ~ 0.1-0.4 cm; thought to represent pre-mortem/perimortem hemorrhage.<ref>{{cite journal \|author=Tsokos M, Rothschild MA, Madea B, Rie M, Sperhake JP \|title=Histological and immunohistochemical study of Wischnewsky spots in fatal hypothermia \|journal=Am J Forensic Med Pathol \|volume=27 \|issue=1 \|pages=70–4 \|year=2006 \|month=March \|pmid=16501354 \|doi=10.1097/01.paf.0000202716.06378.91 \|url=http://journals.lww.com/amjforensicmedicine/Abstract/2006/03000/Histological_and_Immunohistochemical_Study_of.14.aspx}}</ref>
	*Paradoxical undressing; decedent has removed clothes due to perception of being too hot.<ref name=pmid20151230>{{cite journal \|author=Turk EE \|title=Hypothermia \|journal=Forensic Sci Med Pathol \|volume=6 \|issue=2 \|pages=106–15 \|year=2010 \|month=June \|pmid=20151230 \|doi=10.1007/s12024-010-9142-4 \|url=}}</ref>

	~~Notes:~~
	*Findings are often non-specific.<ref name=pmid16948514>{{cite journal \|author=Nixdorf-Miller A, Hunsaker DM, Hunsaker JC \|title=Hypothermia and hyperthermia medicolegal investigation of morbidity and mortality from exposure to environmental temperature extremes \|journal=Arch. Pathol. Lab. Med. \|volume=130 \|issue=9 \|pages=1297–304 \|year=2006 \|month=September \|pmid=16948514 \|doi= \|url=http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282006%29130%5B1297%3AHAHMIO%5D2.0.CO%3B2}}</ref>
	*Non-specific findings seen in hypothermia:<ref name=pmid16948514/>
	**[[Pulmonary edema]].
	**Hemorrhagic pancreatitis.
	**Hemorrhage of the iliopsoas muscle.
	*DDx of reddening of skin includes [[Carbon_monoxide toxicity\|carbon monoxide poisoning]].
	~~Image:~~
	*[http://www.springerlink.com/content/n785314u75m71j8h/fulltext.pdf Wischnewski spots (springerlink.com)].

	~~===Hyperthermia===~~
	~~Features:~~
	*Findings are non-specific.<ref name=pmid16948514>{{cite journal \|author=Nixdorf-Miller A, Hunsaker DM, Hunsaker JC \|title=Hypothermia and hyperthermia medicolegal investigation of morbidity and mortality from exposure to environmental temperature extremes \|journal=Arch. Pathol. Lab. Med. \|volume=130 \|issue=9 \|pages=1297–304 \|year=2006 \|month=September \|pmid=16948514 \|doi= \|url=http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282006%29130%5B1297%3AHAHMIO%5D2.0.CO%3B2}}</ref>
	*Short survival:
	**+/-Petechiae - serosal (pleural, epicardial, pericardial) and cerebral periventricular.
	**+/-Cerebral edema.
	*Long survival:
	**Findings consistent with hypovolemic shock (hepatic [[necrosis]], cerebral edema, [[DAD]] in lung, acute [[pancreatitis]]).
	**Clinical/biochemical: [[rhabdomyolysis]], [[DIC]], [[ATN]].

	~~===Electrocution===~~
	~~====General====~~
	*May be missed - as can be subtle.
	*Usually causes death ~~by [[cardiac arrhythmia]].~~
	*Typically accidents.<ref>{{Cite journal \| last1 = Wick \| first1 = R. \| last2 = Gilbert \| first2 = JD. \| last3 = Simpson \| first3 = E. \| last4 = Byard \| first4 = RW. \| title = Fatal electrocution in adults--a 30-year study. \| journal = Med Sci Law \| volume = 46 \| issue = 2 \| pages = 166-72 \| month = Apr \| year = 2006 \| doi = \| PMID = 16683472 }}~~</ref>~~
	*Occasionally used to suicide.<ref name=pmid19298463>{{Cite journal \| last1 = Dokov \| first1 = W. \| title = Forensic characteristics of suicide by electrocution in Bulgaria. \| journal = J Forensic Sci \| volume = 54 \| issue = 3 \| pages = 669-71 \| month = May \| year = 2009 \| doi = 10.1111/j.1556-4029.2009.01002.x \| PMID = 19298463 }}</ref>

	~~====Gross features====~~
	*Usually burns on the hands - brown.
	**Typically absent if it happened in a wet environment.<ref name=pmid12062943>{{Cite journal \| last1 = Karger \| first1 = B. \| last2 = Süggeler \| first2 = O. \| last3 = Brinkmann \| first3 = B. \| title = Electrocution--autopsy study with emphasis on electrical petechiae. \| journal = Forensic Sci Int \| volume = 126 \| issue = 3 \| pages = 210-3 \| month = May \| year = 2002 \| doi = \| PMID = 12062943 }}</ref>
	*Focal injury suggestive of high voltage (> 1000 V).
	*Lichtenberg figure = fern-like figure.

	~~=====Image=====~~
	~~<gallery>~~
	~~Image:Lightning_injury.jpg \| Lichtenberg figure. (WC)~~
	~~</gallery>~~
	~~====Microscopic====~~
	~~Features:~~
	*Palisading of basal cells (like [[cautery artefact]]).

	=Gunshot wounds=		=Gunshot wounds=

Michael: /* Sharp force injury */

2015-01-28T00:20:09Z

Sharp force injury

← Older revision		Revision as of 00:20, 28 January 2015
Line 616:		Line 616:
	*''Stab''.		*''Stab''.
	*''Chop'' - a mixed injury, sharp force and blunt force.		*''Chop'' - a mixed injury, sharp force and blunt force.

			====Images====
			<gallery>
			Image: Thorax-Messerstichwunden.jpg \| Sharp force trauma - thorax. (WC)
			</gallery>

	=Head injuries=		=Head injuries=

Michael: /* Bite injury */

2015-01-28T00:17:59Z

Bite injury

← Older revision		Revision as of 00:17, 28 January 2015
Line 579:		Line 579:
	*Bite marks, as evidence, have a limited value for identification purposes.		*Bite marks, as evidence, have a limited value for identification purposes.
	**In the context of identifying a potential perpetrator, it is essential to swab the bite mark for saliva, which is rich in DNA.<ref>{{Cite journal \| last1 = Pretty \| first1 = IA. \| title = Forensic dentistry: 2. Bitemarks and bite injuries. \| journal = Dent Update \| volume = 35 \| issue = 1 \| pages = 48-50, 53-4, 57-8 passim \| month = \| year = \| doi = \| PMID = 18277695 }}</ref>		**In the context of identifying a potential perpetrator, it is essential to swab the bite mark for saliva, which is rich in DNA.<ref>{{Cite journal \| last1 = Pretty \| first1 = IA. \| title = Forensic dentistry: 2. Bitemarks and bite injuries. \| journal = Dent Update \| volume = 35 \| issue = 1 \| pages = 48-50, 53-4, 57-8 passim \| month = \| year = \| doi = \| PMID = 18277695 }}</ref>

			====Images====
			<gallery>
			Image: Dog_bite.JPG \| Bite injury. (WC)
			</gallery>

	===Aortic trauma===		===Aortic trauma===