1/35. Petechiae of the baby's skin as differentiation symptom of infanticide versus SIDS.The successive killing of three siblings by their biological mother at two-year intervals is described. The children were 367 days, 75 days and 3 years old. Although sudden infant death syndrome (SIDS) or interstitial pneumonia could not be ruled out as the cause of death in the two younger children, who were killed first, the third child exhibited discrete signs of violence in the mouth and throat area which were interpreted as proof of infanticide. All three children had petechiae of the skin of the face and throat, the upper thorax, the shoulders and the mucous membranes of the mouth. None of the children exhibited signs of a disease-related hemorrhagic tendency. After the mother was convicted of murdering the three-year-old boy by smothering in combination with compression of the thorax, she confessed to having killed the other two children in a similar manner. In the absence of hemostatic disease, the presence of petechiae of the skin extending over the entire drainage area of the Vena cava superior can be regarded as evidence of an increase in pressure in the thoracic cavity secondary to obstruction of the airways with simultaneous chest compression.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/35. Two cases of accidental asphyxia by neck compression between bed bars.Two cases of asphyxia due to compression of the neck between the side bars of a bed in elderly subjects affected by neuropsychiatric pathologies are presented. In both cases no lesions were found on the skin or in the anatomic structures of the neck. The absence of lesions made determining the cause of death difficult. Generic evidence of asphyxia (acute pulmonary emphysema and petechiae) allowed a diagnosis to be formulated. The discovery of the object that caused the death was possible only with information regarding the circumstances and inspection of the scenes of the deaths.- - - - - - - - - - ranking = 2.5keywords = compression (Clic here for more details about this article) |
3/35. Traumatic asphyxia complicated by unwitnessed cardiac arrest.We report a case of traumatic asphyxia complicated by unwitnessed cardiac arrest in which the patient has made a good, functional recovery. Traumatic asphyxia is an uncommon clinical syndrome usually occurring after chest compression. Associated physical findings include subconjunctival hemorrhage and purple-blue neck and face discoloration. These facial changes can mimic those seen with massive closed head injury; however, cerebral injury after traumatic asphyxia usually occurs due to cerebral hypoxia. When such features are observed, the diagnosis of traumatic asphyxia should be considered. Prompt treatment with attention to the reestablishment of oxygenation and perfusion may result in good outcomes.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
4/35. A traumatic asphyxia in a child.PURPOSE: Traumatic asphyxia in a child is rare and the pathophysiology is different from that occurring in an adult. We report a case of traumatic asphyxia in a child who recovered without specific treatment, even though chest and abdominal compression was severe. CLINICAL FEATURES: A three-year-old boy (14.2 kg) was run over by the rear wheel of a Jeep. He was under the tire for about three minutes and then was transferred to our hospital. When he arrived, he was lethargic with glasgow coma scale of E3V4M6 (coma score of 13). He was cyanotic in his face and had a tire mark from the left shoulder to the right abdomen, petechiae on the head, face, conjunctiva and chest, oral bleeding, and facial edema. serum concentrations of liver enzymes were increased and microhematuria was detected. However, no injuries were seen in the brain, eye, chest, or abdomen. cyanosis disappeared in a few hours. Facial and thoracic petechiae disappeared in three days and that of the conjunctiva in five days. He was discharged from hospital on the 13th day without any disturbances. CONCLUSION: We present a three-year-old boy with traumatic asphyxia. He had no complications although he received severe thoraco-abdominal compression by a Jeep.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
5/35. Transfer of biological traces in cases of hanging and ligature strangulation.In hanging and ligature strangulation, the noose mostly causes a mark or groove which is formed partly by compression of the skin and partly by abrasion with loss of the upper epidermal layers. The horny scales abraded from the neck may be transferred to the strangulation device or to the interposed textiles where they are sometimes visible at stereomicroscopic examination or even to the naked eye as silver-grey particles. The morphologic features of the epidermal transfer due to hanging and ligature strangulation is demonstrated by 14 case examples. The biological traces may be sufficient for comparative dna typing by means of PCR-based methods. In 9 out of the 14 cases, genomic dna typing was successful. Analysis of mtDNA succeeded in another two cases, although genomic dna could not be detected. Beside the accumulation of solid epidermic particles the paper describes deposition of serous and fatty tissue fluid at the ligature (mainly adjacent to skin ridges).- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
6/35. A variant of incaprettamento (ritual ligature strangulation) in east timor.Incaprettamento is a ritualized form of ligature strangulation often associated with the Italian Mafia. The hallmarks include ligature strangulation and binding of the body in a highly stereotyped fashion. The bindings include tying the wrists and ankles together, with the body in the prone position (similar to "hogtying"), and an additional ligature encircling the neck and attached to the bindings of the extremities. The binding of the body may be performed after death is inflicted by ligature strangulation, or it may be associated with self-strangulation, as shown by the arrangement of ligatures and the position of the body. A case with great similarities to incaprettamento, in which the body was exhumed from a grave in east timor, is described in detail. However, in addition to prone-position binding and a hyoid fracture, chopping wounds of a knee and blunt trauma to the posterior torso were found. The implication of these wounds is discussed in relation to incaprettamento.- - - - - - - - - - ranking = 0.053981072331841keywords = fracture (Clic here for more details about this article) |
7/35. Strangulation injuries.Strangulation accounts for 10% of all violent deaths in the united states. Many people who are strangled survive. These survivors may have minimal visible external findings. Because of the slowly compressive nature of the forces involved in strangulation, clinicians should be aware of the potential for significant complications including laryngeal fractures, upper airway edema, and vocal cord immobility. survivors are most often assaulted during an incident of intimate partner violence or sexual assault, and need to be specifically asked if they were strangled. Many survivors of strangulation will not volunteer this information. Accurate documentation in the medical chart is essential to substantiate a survivor's account of the incident. Medical providers are a significant community resource with the responsibility to provide expert information to patients and other systems working with survivors of strangulation. This case study reviews a strangulation victim who exhibited some classic findings.- - - - - - - - - - ranking = 0.053981072331841keywords = fracture (Clic here for more details about this article) |
8/35. Mechanical asphyxia by three different mechanisms.We report the case of death of a 75-year-old Caucasian woman, produced by three different ways of mechanical asphyxia: smothering and strangulation by hand and traumatic asphyxia by thoracic compression. All these criminal offences were carried out by one single assailant who compressed the mouth and the nose of the victim with the left hand, squeezed her neck with the right hand and pressed her thorax with the knees.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
9/35. Positional asphyxia: reflection on 2 cases.Positional asphyxia, a fatal condition arising because of the adoption of particular body positions, causing mechanical interference with pulmonary ventilation, can occur in various circumstances that are likely to come under the observation of the specialist in legal medicine (work, car accidents, torture, kidnapping, etc.). It is difficult to diagnose the cause of death in such cases because they generally present with an aspecific anatomopathologic picture. In some situations, positional asphyxia can be hard to distinguish from asphyxia because of chest compression. The main difference is in the way the event occurred: whether the particular position causing the asphyxia had been adopted by choice or by compulsion or necessity when an extrinsic mechanical action would result in traumatic asphyxia. The diagnosis of positional asphyxia is essentially based on 3 criteria: the body position must obstruct normal gas exchange, it must be impossible to move to another position, and other causes of natural or violent death must be excluded. To illustrate the main physiopathologic and diagnostic causes of positional asphyxia, the authors report 2 cases taken from the records of events that came under the observation of the Medico-Legal Sector of Bari University Hospital throughout the last 10 years.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
10/35. Inflicted compressional asphyxia of a child.Compressional or traumatic asphyxia is a well recognized entity to most forensic pathologists. The vast majority of reported cases have been accidental. The case reported here describes the apparent inflicted compressional asphyxia of a small child. A review of mechanisms and related controversy regarding proposed mechanisms is discussed.- - - - - - - - - - ranking = 2.5keywords = compression (Clic here for more details about this article) |
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