{"title":"Post-cardiopulmonary resuscitation trauma: retrospective analysis of skeletal and visceral injuries in autopsy findings.","authors":"Cemyigit Deveci, Batuhan Turgut, Mehmet Atilgan","doi":"10.1007/s12024-025-01028-1","DOIUrl":"10.1007/s12024-025-01028-1","url":null,"abstract":"<p><p>This study evaluates skeletal and visceral injuries associated with CPR, providing insights for clinicians and forensic experts. A retrospective analysis of 520 autopsy cases, selected from 2,508 conducted between 2021 and 2022 in Türkiye, was performed. Inclusion criteria focused on cases receiving CPR post-cardiac arrest, excluding pre-existing thoracic or abdominal trauma. Data were analyzed for demographic variables, injury types, and correlations with age, gender, and body mass index (BMI). Rib fractures were identified in 56.7% of cases, with a median of 9 fractures. Sternum fractures occurred in 42.9%, more frequently in females (55.4% vs. 38.7%; OR = 2.36, 95% CI = 1.50-3.74) and older individuals. Rib fractures were associated with age and BMI, whereas sternum fractures correlated with age and female gender. Lung (13.5%) and cardiac (5.4%) contusions were the most common. Younger individuals (0-17 years) showed fewer skeletal injuries but higher rates of isolated visceral trauma. Skeletal injuries were prevalent in individuals > 50 years, whereas visceral injuries were more common in younger cases. CPR-related injuries exhibit significant variation across demographics. Awareness of these patterns is vital for improving resuscitation protocols and post-CPR evaluations, potentially minimizing trauma.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1222-1229"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C Poulain, T Prigent, B Guibourg, G Le Flahec, E Martin, D Ben Salem
{"title":"A rare complication of a thoracic wound: the pneumopericardium?","authors":"C Poulain, T Prigent, B Guibourg, G Le Flahec, E Martin, D Ben Salem","doi":"10.1007/s12024-025-00952-6","DOIUrl":"10.1007/s12024-025-00952-6","url":null,"abstract":"<p><p>Pneumopericardium (PPC) is defined by the presence of gas in the pericardial cavity, often leading to cardiac tamponade and a high mortality rate. This report describes a case involving a 33-year-old man found deceased a few meters from a knife, his clothes intact, with no resuscitation attempt made. A knotted scarf was tightly fastened around his neck, without ligature mark. Post-mortem CT revealed 271 ml of gas in the pericardial cavity, with \"flattened heart\". The forensic examination revealed two thoracic stab wounds, one penetrated the pericardium without penetrating the heart chamber, while the second remained superficial. In the absence of resuscitation or exsanguination, and in the presence of some non-specific signs observed in the context of asphyxia, the hypothesis of death by compressive PPC was supported. This first French case report of PPC highlights the rarity of this entity in forensic settings, and comparison with other cases described in the literature which did not present the same characteristics points out the diagnostic difficulties it presents and the importance of post-mortem CT in diagnosis.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1551-1555"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johanna Preuß-Wössner, Jan-Peter Sperhake, Burkhard Madea
{"title":"Yellow meconium.","authors":"Johanna Preuß-Wössner, Jan-Peter Sperhake, Burkhard Madea","doi":"10.1007/s12024-024-00932-2","DOIUrl":"10.1007/s12024-024-00932-2","url":null,"abstract":"<p><p>The intestinal content of newborns is known as meconium, usually described as a black-greenish slimy substance. However, in rare cases, meconium might be yellow. This is of great relevance with regard to the forensic assessment of life birth, i.e. (longer) survival time and possible (breast-)feeding before death. While in older German forensic literature, yellow meconium has been occasionally mentioned from the 19th century on - without any conclusions being drawn from this finding whether the newborn was alive or had been fed -, current forensic literature does not provide information about this phenomenon. No reports of yellow meconium were found in (older) English forensic literature as well. We report two cases of newborn autopsies with yellow meconium and provide a short overview of the respective literature.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1561-1565"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafał Skowronek, Jacek Zamłyński, Aleksandra Borowska-Solonynko
{"title":"Usefulness of postmortem computed tomography when neonatal death occurred after fetoscopic endotracheal occlusion- case report.","authors":"Rafał Skowronek, Jacek Zamłyński, Aleksandra Borowska-Solonynko","doi":"10.1007/s12024-025-01036-1","DOIUrl":"10.1007/s12024-025-01036-1","url":null,"abstract":"<p><p>Congenital diaphragmatic hernia is associated with high risk of neonatal death. It is observed in about 1 in 3,000 live births. Fetoscopic tracheal occlusion procedure is a therapeutic option with survival rate 46.4%. Our aim was analysis of the suitability of postmortem computed tomography in the case of neonatal death occurred after fetoscopic endotracheal occlusion performed due to the severe isolated left-sided congenital diaphragmatic hernia. Postmortem computed tomography can be helpful in such cases because it allows for an objective assessment of whether the procedures used after the birth of the newborn enabled effective lung ventilation. Our case was the first use of postmortem computed tomography in neonatal death after fetoscopic endotracheal occlusion worldwide.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1566-1569"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diatoms pass through the gastrointestinal barrier and lead to false-positive: an animal experiment.","authors":"Burkhard Madea, Elke Doberentz","doi":"10.1007/s12024-024-00882-9","DOIUrl":"10.1007/s12024-024-00882-9","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1575-1576"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The under-recognition and significance of frailty syndrome - a geriatric and forensic conundrum.","authors":"Roger W Byard","doi":"10.1007/s12024-024-00900-w","DOIUrl":"10.1007/s12024-024-00900-w","url":null,"abstract":"<p><p>Frailty syndrome occurs in elderly individuals with declining muscle mass (sarcopenia), unintentional weight loss, decreasing physical strength and activity, exhaustion, and slow ambulation. It significantly increases morbidity and mortality with cardiovascular, renal disease and neurological disorders, osteoporosis and fractures, endocrine and immunological dysfunction and a variety of malignancies. It is increasing in incidence as the population ages. However, unfortunately as identification relies on clinical and not pathological evaluations, its contribution to a wide range of comorbidities and its role in terminal episodes may not be recognized in a forensic context.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1500-1503"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlota Jardim Gomes, Marta Heitor, Joana Albuquerque, Ana Rita Inácio
{"title":"External causes of death in younger than 18 years old in Portugal in the last 10 years - a retrospective analysis.","authors":"Carlota Jardim Gomes, Marta Heitor, Joana Albuquerque, Ana Rita Inácio","doi":"10.1007/s12024-025-00997-7","DOIUrl":"10.1007/s12024-025-00997-7","url":null,"abstract":"<p><p>Pediatric mortality from external causes has been a worldwide concern in the last decades. In particular, the prevalence of accidental deaths is a key concern, especially traffic accidents. This is retrospective study based on autopsy reports of violent deaths in individuals younger than 18 years from 2014 to 2023 in Portugal, aimed at providing valuable insight in order to help formulate preventive strategies. There were 554 pediatric deaths due to exogenous causes, with a predominance of males (68,95%). Adolescents were the most prevalent age group. The leading cause of death was land transport injury (38,27%). Asphyxia-related deaths were predominant in younger age groups. Accidental deaths accounted for 76,71% of all cases. Preventable injury-related causes continue to be a major contributor to child mortality. The inconsistent mortality rates from various mechanisms emphasize the necessity for targeted and effective preventive measures. Above all, land transport accidents seem to be an issue in need of prompt intervention.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1183-1190"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annachiara Vinci, Laura Laura Ambrosi, Marcello Benevento, Davide Ferorelli, Biagio Solarino
{"title":"A singular case of complex suicide by hanging with hesitation marks by axe.","authors":"Annachiara Vinci, Laura Laura Ambrosi, Marcello Benevento, Davide Ferorelli, Biagio Solarino","doi":"10.1007/s12024-025-00964-2","DOIUrl":"10.1007/s12024-025-00964-2","url":null,"abstract":"<p><p>We present a case of complex suicide concerning a 55-year-old man who hanged himself using a rope anchored to a beam on the terrace of his apartment. Multiple parallel linear wounds were observed on his head. At the crime scene, an axe stained with blood and hair was found resting against the wall adjacent to the stairs leading to the upper floor. Forensic investigations identify the cause of death as mechanical asphyxia due to the hanging, in a complex suicide characterized by hesitation marks inflicted on the head with an axe. This specific type of complex suicide has never been described in the literature.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1515-1519"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Learning to read and interpret tattoos.","authors":"Roger W Byard","doi":"10.1007/s12024-025-00940-w","DOIUrl":"10.1007/s12024-025-00940-w","url":null,"abstract":"<p><p>Tattooing has been a facet of many civilizations and cultures for millennia with a recent resurgence in popularity in many Western countries. The reasons for tattooing are diverse ranging from simple decorative designs to enforced tattooing of concentration camp inmates. In a forensic context tattoos are frequently observed and may play a role in some cases of identification, even after decomposition, incineration or dismemberment. More broadly however, tattoos can provide significant information on a decedent's name and age, country or region of origin, religion, names of family members and friends, pet ownership, political affiliations, sporting and recreational activities, military service, gang memberships, drug usage and medical data. Thus, careful reading of tattoos at the time of post mortem examination can sometimes be a very productive exercise delivering background material on a decedent that may not have been provided in police reports.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1511-1514"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pascale Basilicata, Antonio Lombardi, Mariagrazia Marisei, Emanuele Capasso, Angela Simonelli, Maria Pieri
{"title":"Cocaine and aortic dissection: the need for collaboration to overcome the underreporting bias.","authors":"Pascale Basilicata, Antonio Lombardi, Mariagrazia Marisei, Emanuele Capasso, Angela Simonelli, Maria Pieri","doi":"10.1007/s12024-025-00951-7","DOIUrl":"10.1007/s12024-025-00951-7","url":null,"abstract":"<p><p>The dissection of the aorta is a serious and potentially fatal consequence of cocaine use. Nonetheless, the underlying mechanisms and characteristics of this phenomenon remain to be deeply studied. The autopsy case of a 46-year-old white male found irresponsive and unconscious in his house and had a history of abusing cocaine is presented. Autopsy findings showed aortic arch and thoracic aorta of regular calibre, with evidence of a mid-adventitial dissecting aneurysm of the ascending intrapericardial portion of the aorta. Forensic toxicological analyses evidenced a positivity to cocaine and its main metabolite, benzoylecgonine, in all fluids (peripheral blood, bile and urine), liver and brain homogenates. Data also evidenced a positivity to alcohol, confirming a past history of intake. The presented case confirms the connection between cocaine addiction and the risk of aortic dissection, emphasizing the need for increased knowledge about the risks connected to this drug. It is emphasized the need of prompt examination and effective treatment of patients exhibiting cardiac symptoms linked to cocaine use, as well as the need of an accurate anamnesis to evidence use/abuse of other cardiotoxic substances.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1281-1286"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}