1/19. Tentative injuries to exposed skin in a homicide case.A 28-year-old man stabbed both his wife and his 3-year-old son to death, before unsuccessfully attempting to commit suicide. The incident occurred against a background of marital conflict. The child's body exhibited six tentative wounds to the skin in the area of the heart, with no corresponding defects in the overlying clothing, a pattern normally seen only in suicide. Their presence can be explained by the fact that this can be considered an extended suicide, the father's motivation for the killing being comparable to that for true suicide. However, wounds of this nature can be produced in such cases only if the victim is severely limited in his ability to defend himself, here due to the superior physical strength of the father.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/19. A biomechanical reconstruction of a wound caused by a glass shard--a case report.During the course of a criminal trial, an investigating pathologist is commonly asked how much force was required to produce an injury. This subjective opinion is based on the pathologist's previous experience of dealing with wounds inflicted with similar weapons. However, in the case of stab wounds inflicted by broken glass, it is unlikely that two glass fragments would be physically similar. In the case studied, two theories were examined: that a wound resulted from a thrown glass fragment or that it had been caused as a stab injury by the glass held in the bare hand. The investigation involved quantifying the energy required for human tissue penetration, comparison of sharpness, a biomechanical analysis of throwing actions and testing of the hypothesis that if the glass shard were used as a stabbing implement it would result in a cut to the hand.The investigation utilised a scientific methodology that reduced the need for speculative (though informed) opinion from the pathologist by producing quantitative results.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/19. Injury caused by deeply penetrating knife blade lodged in infratemporal fossa.Knife-inflicted, deeply penetrating head and neck trauma is an uncommon life-threatening injury and a challenging problem. An examination of the neurovascular and systemic physical status is a first requirement and the decision as to which approach to adopt for the removal of the blade is of critical importance. Here we report a rare case of a pre-auricular stab wound with the knife blade deeply lodged in the extracranial infratemporal fossa. Radiological investigations showed that the knife blade had entered from the temporomandibular joint and become lodged through the anterior margin of foremen magnum below the petrosal bone. Minimal left vocal cord paresis, left palatal weakness and a slight deviation of the tongue towards the left side were observed. The other neurological and systemic physical evaluations were normal. Simple withdrawal of the blade in the operating room did not cause serious neurovascular injury. Here we discuss and compare the expanded exposure of anatomical structures for blade removal and simple withdrawal in similar injuries.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
4/19. Internal carotid artery pseudoaneurysm masquerading as a peritonsillar abscess.Blunt carotid arterial injuries are uncommon. Motor vehicle crashes are the most frequent cause, but this type of vascular injury can be secondary to any direct blow to the neck, intraoral trauma, or strangulation. Types of vascular injuries include dissection, pseudoaneurysm, thrombosis, rupture, and arteriovenous fistula formation. patients with pseudoaneurysm of the internal carotid artery will usually present with neurologic complaints, ranging from the minor to complete stroke. On physical examination, neck hematoma, bruits, pulsatile neck mass, or a palpable thrill may be found. However, in 50% of cases, no external signs of neck trauma are observed. Onset of symptoms may occur within a few hours to several months after the initial injury. angiography is considered the gold standard for diagnosis, but carotid Doppler ultrasound recently has been shown to be very sensitive in detecting these types of injuries. Treatment of pseudoaneurysm is often surgical, with endovascular stenting.- - - - - - - - - - ranking = 7.4391832726302keywords = physical examination, physical (Clic here for more details about this article) |
5/19. Accidentally discovered large metallic intra-orbital foreign body.A 6.2 cm long and 2.7 cm thick metallic foreign body was accidentally found and removed from a 62 years old man. He was sent to a minor operation theater for repair of left lower lid laceration secondary to trauma after a fight. Subsequent investigation, management, patient follow-up and outcome are discussed. Importance of careful history taking, thorough physical examination and proper investigations are stressed.- - - - - - - - - - ranking = 7.4391832726302keywords = physical examination, physical (Clic here for more details about this article) |
6/19. An unusual suicide by stabbing: a case report.A 50-year old cobbler, employed in a paramilitary unit, was found dead in a pool of blood in his shop inside the unit line in the morning. He had multiple stab wounds on his chest and was alleged to have committed suicide by repeated self-stabbing on the chest with a sharp iron chisel, which was found clenched in his right hand by the investigating officer. Fifteen wounds were communicating with the chest cavity, injuring the vital anatomical structures. The individual, according to the unit personnel, was not suffering from any physical or mental disorder and was not on any medication.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/19. High output heart failure 8 months after an acquired arteriovenous fistula.Congestive heart failure (CHF) due to hyperkinetic states can occur in systemic diseases and in arteriovenous fistulas. An 18 year old Turkish male patient complaining of dyspnea and palpitations, who had suffered a stab wound to his abdomen eight months earlier, was admitted to our clinic. auscultation revealed a systolodiastolic murmur over the entire abdomen. Chest x-rays demonstrated significant cardiomegaly. echocardiography revealed biatrial enlargement and significant mitral and tricuspid regurgitation accompanied by dilatation of the inferior vena cava. Right heart catheterization showed increased oxygen saturation at the inferior vena cava. A diagnosis of an aortocaval fistula was made by aortography. The symptoms subsided and valvular regurgitations ceased alter surgical correction. This rare case demonstrates the significance of routine physical examination and history of the patient.- - - - - - - - - - ranking = 7.4391832726302keywords = physical examination, physical (Clic here for more details about this article) |
8/19. Small bowel perforation associated with intraperitoneal and extraperitoneal bladder perforation caused by stab wound to the penis.We report an unusual case of small bowel and bladder perforation caused by a stab wound to the penis with preservation of intact corporeal penile bodies and urethra. diagnosis of bladder perforation was made by the urethrogram and diagnosis of small bowel perforation was made by clinical signs even though the initial physical examination suggested neither of these conditions.- - - - - - - - - - ranking = 7.4391832726302keywords = physical examination, physical (Clic here for more details about this article) |
9/19. paper clip stab wounds: four case reports.Four prisoners recently evaluated at a county hospital sustained self-inflicted paper clip stab wounds of the abdomen on 22 occasions. Guidelines for management based on physical examination, abdominal films and wound exploration with paper clip extraction and short-term admission for observation have been successful in avoiding laparotomy in most instances. Evaluation and surgical treatment of penetrating abdominal injuries are controversial. Some authors propose mandatory laparotomy for all stab wounds violating the peritoneum, while others recommend selective management based on physical findings, local exploration of the wound and subsequent peritoneal lavage. Recently, four prisoners have inserted sharpened paper clips into and through the abdominal wall on 22 occasions, raising questions about the appropriate treatment of these injuries. These wounds differ from other stab wounds in several respects: 1) underlying psychiatric disturbances and the self-inflicted nature of the wound increase the difficulty of patient management; 2) attempts are often multiple, precluding repeated peritoneal lavage for evaluation; 3) the foreign body may be completely intraperitoneal; and 4) peritoneal penetration is similar to that incurred during a peritoneal tap with an 18-gauge needle. The differing presentations of these patients are reported, and a plan for management of these injuries is proposed.- - - - - - - - - - ranking = 8.4391832726302keywords = physical examination, physical (Clic here for more details about this article) |
10/19. survival time in gunshot and stab wound victims.Forensic pathologists are often asked to estimate postinjury survival time and to render an opinion on the probable extent of physical activity following fatal injury. To study this question, the case files of the Dade County Medical Examiner's Office were reviewed. The year 1983 was chosen arbitrarily for this study and all the autopsy reports of gunshot or stab wound victims whose survival period satisfied criteria established for this study were reviewed. The data were compared to those from a similar study done in 1961. In addition, this study noted the presence and influence of drugs or alcohol on the cause of death and the postinjury survival time.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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