Journal of forensic and legal medicine最新文献

{"title":"Intrinsic factors influencing the post-mortem mechanical excitability of human skeletal muscle","authors":"H. Stigter, J. Kloosterman, T. Krap, W.L.J.M. Duijst","doi":"10.1016/j.jflm.2025.103055","DOIUrl":"10.1016/j.jflm.2025.103055","url":null,"abstract":"<div><h3>Background</h3><div>Post-mortem, supravital muscle reaction (SMR) of human skeletal muscle is dependent on energy supply. Intrinsic variables, like peri-mortem body temperature and underlying diseases, influence the rate of cell metabolism in skeletal muscle cells post-mortem, and thus the available energy for SMR.</div></div><div><h3>Objectives</h3><div>A field study was conducted, comprising deceased found under differing conditions. We investigated the influence of the body temperature of the deceased on the outcome of post-mortem mechanical stimulation of skeletal muscle in the first hours post-mortem. In addition, we investigated the influence of sex, age, state of rigor mortis and the length of the dying process on SMR. Furthermore, we hypothesized that the outcome of post-mortem muscle stimulation could differ between musculus biceps brachii (MBB) and the musculus brachioradialis (MBR) on the same body examined at the same time, due to a higher cooling velocity of more peripheral located skeletal muscles (MBR).</div></div><div><h3>Methods</h3><div>In the period of January 2017 to August 2023 four forensic physicians from two different regions in the Netherlands performed mechanical stimulation of both upper and forearms of deceased with a known or an estimated PMI of <14 h, by using a reflex hammer. The research population concerned in-hospital-deaths, out-of-hospital deaths that were transferred to the morgue of a hospital, and out-of-hospital deaths that were examined at the place where the body was found. The sex and age of the deceased, body temperature, and state of rigor mortis were registered in the Dutch national register of forensic medicine, which was used as a data resource. The length of the dying process was registered separately using SPSS 27.0 which also served as a data resource. The Welch Two Sample <em>t</em>-test, chi-squared test, logistic regression and multiple logistic regression were performed to investigate the influence of the PMI, body temperature, sex, age, state of rigor mortis and the length of the dying process on the outcome of SMR. Statistical analyses were performed by using R 4.4.1. Significance was accepted at P < 0.05.</div></div><div><h3>Results</h3><div>In total, 142 cases were included, in which musculus biceps brachii (MBB) and the musculus brachioradialis (MBR) on both arms were mechanically stimulated with a reflex hammer. The population consisted out of 65 males (mean age: 73.4 ± 16.8 years) and 77 females (mean age: 82.1 ± 13.0 years). SMR was present in 74 out of 142 cases (52.1 %). The mean PMI did not differ significantly between cases with a positive SMR (157.3 min) and cases showing no SMR (168.4 min). The number of male cases that showed SMR (63.1 %) was significantly higher than the number of female cases (42.9 %) that showed SMR. No relationship was detected between age, body temperature, rigor mortis and the length of the dying process, and the outcome of post-mortem musc","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103055"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829421","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":"Crossing Borders: A look at migrant deaths in the Caribbean","authors":"Ken Obenson","doi":"10.1016/j.jflm.2025.103042","DOIUrl":"10.1016/j.jflm.2025.103042","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103042"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851757","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":"Medicolegal analysis of alleged and judicially proven malpractice claims in Alexandria Medical Syndicate, Egypt","authors":"Zahraa Khalifa Sobh ,&nbsp;Mohamed Ashraf Saad Galal ,&nbsp;Maha Abdelhamied Ghanem ,&nbsp;Hend Mostafa Ali Ali ,&nbsp;Ahmed Mohamed Abdelgawad ,&nbsp;Manal Ibrahim Fathy Balah","doi":"10.1016/j.jflm.2025.103020","DOIUrl":"10.1016/j.jflm.2025.103020","url":null,"abstract":"<div><div>The medicolegal analysis of malpractice claims could guide the reduction of lawsuits and improve medical services. Therefore, this study examined files of 311 malpractice claims investigated by the Alexandria Medical Syndicate in Egypt over five years (2018–2022). A total of 416 physicians were accused. Claims have increased over the past three years (2020–2022). Malpractice was ruled out in 80.4 % of claims, while it was judicially proven in 11.3 %. The legal outcome was undetermined in the remaining claims that ended with the plaintiff waiving or the physician's death. The highest percentages of proven claims were against gynecologists/obstetricians (17.4 %), plastic surgeons (14.3 %), and general surgeons (12.3 %). Regarding patients, 14.1 % of claims from males and 8.6 % of claims from females were proven. Concerning healthcare facilities, the highest rates of proven claims were in private clinics (17.4 %). The most frequent types of proven medical errors were pharmaceutical errors (45.5 %), negligence (16.8 %), and mistakes in care (14.2 %). Patient harm behind these claims ranged from temporary injury (32.9 %), residual damage (15.8 %), permanent infirmity (20.3 %), to death (31.7 %). The highest percentages of proven claims involved infirmities (18.3 %) and deaths (15.9 %) (p = 0.046). Optional procedures had the highest rate of proven surgery-related claims (17.9 %), with errors mainly occurring during the preoperative period (30 %). Malpractice was excluded due to providing standard care (77.8 %). Also, when harm was considered a complication (68.8 %) or a consequence of underlying disease (36 %). The current results could guide future measures to safeguard the rights of patients and healthcare providers in Egypt.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103020"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145527771","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":"Medical liability related legislation and insurance policies around the world: A narrative literature review","authors":"Ioannis Ketsekioulafis ,&nbsp;Konstantinos Katsos ,&nbsp;Dimitrios Kouzos ,&nbsp;Chara Spiliopoulou ,&nbsp;Theodoros Lytras ,&nbsp;Emmanouil I. Sakelliadis","doi":"10.1016/j.jflm.2025.103040","DOIUrl":"10.1016/j.jflm.2025.103040","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Medical law defines the rules of healthcare by specifying the rights of healthcare consumers while at the same time defining the obligations of healthcare providers. When clinicians fail to provide the standard of care, medical malpractice claims arise, leading to medical liability. While many malpractice claims allege deviation from the &lt;em&gt;lex artis&lt;/em&gt;, a substantial proportion do not ultimately establish negligence and are dismissed or settled without a finding of fault. Due to the significant impact of medical negligence on the quality of medical care, as well as on the domestic and global economy, different countries adopt different systems for managing these disputes. Finally, the mandatory or non-mandatory medical malpractice insurance makes doctors carry out their medical work without the fear of medical liability. In fact, in most countries today, doctors are given the opportunity to choose between claims-made and occurrence-based policies of medical malpractice insurance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;The study is a narrative review of scientific and legal works from different countries. For the comparison of medical liability systems and insurance policies a comprehensive review of databases and legal texts was conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This study compares medical liability and malpractice insurance systems across countries, examining variations in the handling of malpractice claims and their implications. The system is adversarial in many countries, especially in the United States, to allow for a substantial compensation, while other countries, such as the United Kingdom and Germany, focus on mediation and structured compensation processes. Notably, France, Japan and other countries follow a no-fault system, of reasoning that the system is more efficient in the sense that it reduces the patient's burden of proving negligence and thus expedites the compensation. These findings reveal how each country negotiates the balance between patient rights and healthcare provider protections, and, in turn, how these negotiations affect malpractice insurance costs and legal reforms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The analysis contrasts fault-based systems which offer large compensation awards with no-fault systems which focus on quick compensation but may lack accountability. Countries with high litigation rates like the US and Brazil have higher insurance costs, while countries like Canada and Australia have stabilized their systems through reforms. Medical liability insurance options, claims-made versus occurrence-based, raise different economic and legal concerns. Occurrence-based policies are more expensive for younger professionals, but they provide longer-term coverage than claims-made policies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Global medical liability frameworks vary considerably, reflecting cultural, economic and legal contexts. However, the compari","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103040"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577826","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":"An investigation of shored gunshot exit wound morphologies using a range of forensically relevant surfaces","authors":"Bandula Nishshanka ,&nbsp;Chris Shepherd ,&nbsp;Randika Ariyarathna ,&nbsp;Paranitharan Paranirubasingam ,&nbsp;Amila Rathnayaka","doi":"10.1016/j.jflm.2025.103035","DOIUrl":"10.1016/j.jflm.2025.103035","url":null,"abstract":"<div><div>Shored exit wounds are produced when the skin at the point of the bullet exit is supported or buttressed by some object or surface, causing an abraded ring around the shored exit wound. This work looks to add critical understanding of shored wound processes on a range of surface types, expanding on the currently limited literature that focuses only on soft shoring materials. This large empirical study was conducted to develop a deeper understanding of shored exit wounds for a range of common surface types available in contemporary urban environments. To facilitate this, two ammunition types (5.56 mm and 7.62 mm) were fired into a porcine model designed to simulate the downward force of a human body pressing into various modern building materials. The exit wounds produced by shoring the porcine model on wall tiles, concrete, and two engineered wood types (MDF and Melamine) significantly contrast with the existing, more generalised explanation of shored exit wounds. This highlights the necessity for a more valid, target-type-specific approach to interpreting shored exit wound characteristics. The study highlights that hard-shoring surfaces produce comparatively larger exit wounds, while irregular surfaces give rise to increased shoring and soft surfaces under pressure, produce less shoring. It also reports novel shored exit wound features and wounding mechanisms not documented previously that have potential forensic investigative value in helping determine if a gunshot wound has resulted from a shored scenario or not. While significantly adding to the understanding of shored exit wounds for forensic pathology practice, the study's findings suggest that the shored exit wound characteristics can be interpreted according to different target types, such as yielding and non-yielding surfaces.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103035"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621561","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":"Revolutionizing forensic DNA analysis: The potential of CRISPR-Cas9 technology in genetic investigations","authors":"Pallavi Kumari ,&nbsp;Vinayak Gupta ,&nbsp;Anjali Chhikara ,&nbsp;Jyoti Dalal","doi":"10.1016/j.jflm.2025.103047","DOIUrl":"10.1016/j.jflm.2025.103047","url":null,"abstract":"<div><div>The newest achievements in the field of molecular biology and gene-editing technologies have transformed the paradigm of forensic DNA analysis. However, there are still great difficulties in interpreting degraded, low-template, mixed genetic samples. The review critically evaluates the transformative potential of Clustered Regularly Interspaced Short Palindromic Repeats and an associated protein 9 (CRISPR-Cas9) as an accurate, effective, and cost-efficient system of genome-editing in the field of forensic science. Based on the evidence of the current literature, the paper critically analyzes the mechanisms of CRISPR-Cas9 activity, its RNA-guided specificity, dual-strand cleavage, and high-fidelity targeting, and compares its functionality with other standard methods like the STR and SNP profiling. The review also discusses more complex CRISPR-based diagnostic systems, such as SHERLOCK, DETECTR, and HOLMES that allow the analysis of DNA rapidly, without amplification, and in a portable format. Among major discoveries, there is the ability of CRISPR to increase the accuracy of DNA profiling, resolve mixture, recapitulate damaged genetic material, and reduce the possibility of contamination. In addition to genetic analysis, it has applications in forensic epigenetics, prediction of phenotypes, microbial forensics and environmental trace analysis. The review also covers the ethical, legal and governance implications of implementing CRISPR-based evidence in the judicial process especially in as far as data privacy; admissibility and equity of access are concerned. In general, CRISPR-Cas9 is a paradigm shift in forensic genomics, the one that has the potential to transform personal identification, reconstruction of the crime scene, and the interpretation of molecular evidence. Future efforts should focus on method validation, standardization, and ethical governance to ensure the responsible and sustainable implementation of this technology in forensic practice.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103047"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733541","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":"Key findings in forensic pathology assessment of deaths following conducted energy weapon exposure – an overview","authors":"Gabriele Napoletano ,&nbsp;Biancamaria Treves ,&nbsp;Alessandro Ghamlouch ,&nbsp;Fabio del Duca ,&nbsp;Maura Racciatti ,&nbsp;Gaia De Angelis ,&nbsp;Paola Frati ,&nbsp;Aniello Maiese","doi":"10.1016/j.jflm.2025.103058","DOIUrl":"10.1016/j.jflm.2025.103058","url":null,"abstract":"<div><div>Conducted Energy Devices (CEDs) or Conducted Energy Weapons (CEWs) are devices supplied to police and military forces worldwide, developed as a less-lethal option to disarm and immobilize individuals in dangerous situations. Their use in countries where they have been extensively adopted has reduced mortality during arrests by two-thirds and emergency medical interventions related to police actions by 80 %. Although adverse effects and complications from CEW application are very rare considering their widespread use, ocular, cranioencephalic, cutaneous, and pulmonary injuries have been reported. Fatal cases mainly involved traumatic brain injury and severe burns caused by the ignition of explosive substances. While negative effects on cardiac electrical activity appear theoretically possible, they can only be substantiated by following specific investigative steps. A literature review conducted between 2010 and 2025 highlights the key aspects for a forensic assessment. It discusses the critical findings on which forensic experts should focus to ensure comprehensive collection of all evidence necessary for reconstructing the mechanism of death. Circumstantial data and injury dynamics would benefit from the use of police body cameras as well as electrocardiographic tracings from Automated External Defibrillators (AEDs) available to law enforcement. Medical personnel should carefully document the location and penetration depth of the probes, especially in very thin individuals, and when penetration occurs between intercostal spaces or near the pericardium. Furthermore, autopsy, histological, toxicological, and genetic investigations should be undertaken to exclude other pathologies that may account for sudden death. In the forensic field, it may be useful to shed more light on CEW-related fatalities and cases of sudden death in young individuals. Although the latter may involve anatomically slender subjects, they may also present undiagnosed genetic or psychiatric conditions or have used novel psychoactive substances not yet identified.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103058"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836754","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 use of contrast and non-contrast post-mortem computed tomography (PMCT) in coronial autopsy clinical practice: Results from an audit of 268 cases","authors":"Alexander Matthews ,&nbsp;Yeafan Xi ,&nbsp;Claire French ,&nbsp;Nigel Cooper","doi":"10.1016/j.jflm.2025.103056","DOIUrl":"10.1016/j.jflm.2025.103056","url":null,"abstract":"<div><h3>Background</h3><div>Little guidance exists on where post-mortem computed tomography with coronary angiography (PMCTA) may be advantageous compared with non-contrast post-mortem computed tomography (PMCT) alone. A large sample of post-mortem cases which utilised PMCT or PMCTA was analysed to elucidate any patterns in their respective use.</div></div><div><h3>Methods</h3><div>All cases referred to our department for post-mortem examination by His Majesty's (HM) Coroners across the 3-month period of December 2023, January 2024, and February 2024 were eligible for inclusion in this study. To be included, cases must have had PMCT or PMCTA prior to autopsy. Where autopsy was performed prior to the post-mortem cross-sectional imaging, these were excluded. Relevant information including age, co-morbidities, and peri-mortem history was retrospectively extracted from the respective post-mortem report for all included cases. Coronary artery calcification (CAC) score was also investigated for its ability to predict coronary artery disease as cause of death.</div></div><div><h3>Results</h3><div>A total of 268 cases were included and analysed. PMCTA was requested more frequently in patients aged 70 or over but offered useful information more often in patients under 70 (p &lt; .001). Peri-mortem history and the presence of co-morbidities did not influence scan type requests (p &gt; .05 in all factors tested). PMCTA may have added value by negating the need for invasive autopsy in 13/268 (4.9%) of cases. There was a moderately positive correlation between CAC score and radiologist reported degree of coronary artery stenosis on PMCTA (agreement in 82/114 cases, 71.9%; χ² statistic = 21.86, p &lt; .001; r = +0.33, p &lt; .001).</div></div><div><h3>Conclusions</h3><div>There was extensive intra-departmental variation in scan type requests supporting coronial autopsies. There were limited patterns on which recommendations could be made for differential use of PMCTA and non-contrast PMCT going forward. In a significant number of cases PMCTA was able to add value by providing additional information which prevented the need for invasive autopsy. PMCTA may be more useful in those aged under 70 compared to those over 70. Using a CAC score threshold of &gt;400 from PMCT alone could lead to overdiagnosis of coronary artery disease as cause of death.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103056"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836757","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":"Intra-puparial development of forensically important Sarcophaga princeps at different constant temperatures","authors":"Liangliang Li ,&nbsp;Yifei Li ,&nbsp;Yinghui Wang ,&nbsp;Yu Wang","doi":"10.1016/j.jflm.2025.103022","DOIUrl":"10.1016/j.jflm.2025.103022","url":null,"abstract":"<div><div><em>Sarcophaga princeps</em> Wiedemann, 1830 (Diptera: Sarcophagidae) is a species widely distributed in the Oriental and parts of the Palearctic regions. Documented cases have reported its colonization of human corpses and association with livestock myiasis, highlighting its significant value in forensic and medical research. However, current methods for estimating the intra-puparial age of <em>S. princeps</em>, which accounts for more than half of the entire immature stage, remain lacking. In this study, pupae were sampled at four constant temperatures (16, 22, 28, and 34 °C), and intra-puparial morphological changes were observed and photographed under a stereomicroscope after removal of the puparium. Results showed that the intra-puparial developmental period of <em>S. princeps</em> could be divided into 12 sub-stages based on overall morphological changes. Structures such as compound eyes, mouthparts, antennae, thorax, legs, wings, and abdomen were also used for age estimation; these were individually observed, photographed with local magnification, and their developmental processes were categorized into 6–10 stages. The temporal ranges of each sub-stage and structural appearance were meticulously recorded. This study provides essential baseline data for estimating minimum postmortem interval (PMI_min) using intra-puparial morphological characteristics of <em>S. princeps</em>.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103022"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515219","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":"Hemorrhage in cervikal muscles: A case of drowning in the River","authors":"Abuzer Gülderen ,&nbsp;Tuba Şahinoğlu Güneş ,&nbsp;Sertaç Dalgıç ,&nbsp;Veysel Gürbüz ,&nbsp;Selçuk Çetin","doi":"10.1016/j.jflm.2025.103038","DOIUrl":"10.1016/j.jflm.2025.103038","url":null,"abstract":"<div><h3>İntroduction and Aim</h3><div>Ecchymosis and intramuscular hemorrhages seen in the superficial and deep muscle groups of the neck are instructive findings in terms of detecting and defining the pressure and trauma applied to the neck area. In our study, we aimed to present a drowning case in which bilateral sternocleidomastoid muscle bleeding was detected without any findings indicating neck compression or trauma.</div></div><div><h3>Case</h3><div>30-year-old man was found dead in a river near our city. He was referred to us by the prosecutor's office for an autopsy and to determine the cause of death. At autopsy; Bleeding was observed in the part of the sternocleidomastoid muscle close to the clavicle, under the fascia and within the muscle. Comprehensive examination, crime scene examination and autopsy findings were evaluated together. Bleeding that occurred in the neck region of the patient without external trauma was evaluated as intramuscular bleeding that rarely developed in the neck muscles during the drowning.</div></div><div><h3>Discussion and conclusion</h3><div>Forced inspiratory muscles do not function during normal breathing. They function in physiological and pathological conditions where respiratory volume must be increased. Among these muscles, the sternocleidoimastoid muscle is responsible for increasing the toraks volume by lifting the sternum up. It is an expected situation to see forced inspiration-expiration and related findings in deaths due to drowning. However, intramuscular hemorrhages that may occur due to forced inspiration-expiration are rare findings. In such cases, external neck trauma and compression should be excluded before making a decision.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"117 ","pages":"Article 103038"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590490","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}