Medico-Legal Journal最新文献_第2页

Venepuncture-related nerve injury in medico-legal practice. 法医学实践中的静脉穿刺相关神经损伤。

Medico-Legal Journal Pub Date : 2026-10-08 DOI: 10.1177/00258172261460430

Ashley I Simpson

引用次数: 0

Forensic physician's dilemma: Attempted suicide or homicide? A case report of an atypical cut-throat injury. 法医的困境：自杀未遂还是他杀？非典型割喉伤1例报告。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-04-19 DOI: 10.1177/00258172261433789

Paranavidana Roshel Claude Wijenayaka, Usliyanage Clifford Priyantha Perera, Pradeep Rohan Ruwanpura

{"title":"Forensic physician's dilemma: Attempted suicide or homicide? A case report of an atypical cut-throat injury.","authors":"Paranavidana Roshel Claude Wijenayaka, Usliyanage Clifford Priyantha Perera, Pradeep Rohan Ruwanpura","doi":"10.1177/00258172261433789","DOIUrl":"10.1177/00258172261433789","url":null,"abstract":"Cut-throat injuries are among the most serious forms of sharp force trauma encountered in medico-legal practice and frequently present complex interpretative challenge as they may suggest suicide, homicide or rarely, be accidental. particularly when classical morphological features are absent. In this case a 48-year-old woman with a history of depressive disorder presented with a deep transverse incised wound to the anterior neck, requiring emergency tracheostomy and surgical repair. Operative findings revealed two full-thickness incisions involving the thyroid cartilage and thyrohyoid membrane, with sparing of major cervical vessels. The wound margins were irregular with no hesitation cuts or tailing observed. No defence injuries were identified. The victim was found inside a locked washroom and a paper cutter knife was discovered nearby. Forensic psychiatric evaluation revealed active suicidal ideation. Despite the atypical wound morphology, the collective clinical, circumstantial and psychiatric findings supported a self-inflicted injury. This case highlights the importance of holistic medico-legal analysis and cautions against reliance on morphology alone in determining manner.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"173-176"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Silent but fatal: Sudden death from asymptomatic severe aortic stenosis. 无声但致命：无症状严重主动脉瓣狭窄导致猝死。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-05-19 DOI: 10.1177/00258172261442700

Paranavidana Roshel Claude Wijenayaka, Ajith Rathnaweera

{"title":"Silent but fatal: Sudden death from asymptomatic severe aortic stenosis.","authors":"Paranavidana Roshel Claude Wijenayaka, Ajith Rathnaweera","doi":"10.1177/00258172261442700","DOIUrl":"10.1177/00258172261442700","url":null,"abstract":"Aortic stenosis (AS) is the most common valvular heart disease and typically progresses slowly, often becoming symptomatic in older people. Sudden death in previously asymptomatic individuals is rare, particularly in middle-aged adults. We report a case of a 48-year-old male carpenter who collapsed while engaging in his routine work. He was pronounced dead shortly after arrival at hospital. Medico-legal autopsy revealed a markedly enlarged heart weighing 682 g. The aortic valve was severely stenosed, heavily calcified and distorted, producing an orifice of approximately 1 cm. The valve appeared to have two cusps, suggesting possible congenital bicuspid morphology, though definitive confirmation was precluded by advanced calcification. The left ventricle demonstrated symmetrical concentric hypertrophy with a wall thickness of 2.5 cm. No right ventricular hypertrophy, septal asymmetry or pulmonary oedema were observed. Histology confirmed hypertrophied myocardial fibres without myofibrillar disarray or fibrosis. Urine toxicology was negative. Death was attributed to severe aortic stenosis, with the probable mechanism being fatal arrhythmia precipitated by exertion. This case highlights the silent but potentially fatal nature of severe AS, the importance of thorough autopsy examination, and the value of forensic insight in sudden unexpected deaths.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"196-199"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fatal fall causing isolated thoracic impalement with bi-ventricular cardiac rupture. 致命的跌落导致孤立的胸椎穿刺并双心室心脏破裂。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-05-19 DOI: 10.1177/00258172261441440

Paranavidana Roshel Claude Wijenayaka, Janaki Warushahennadi

{"title":"Fatal fall causing isolated thoracic impalement with bi-ventricular cardiac rupture.","authors":"Paranavidana Roshel Claude Wijenayaka, Janaki Warushahennadi","doi":"10.1177/00258172261441440","DOIUrl":"10.1177/00258172261441440","url":null,"abstract":"Falls from a height usually cause blunt trauma involving multiple body regions, but penetrating injuries are relatively uncommon; they occur when a rigid object penetrates the body. This can cause catastrophic internal damage depending on the structures involved. We report a fatal case of isolated thoracic impalement in a 49-year-old man who reportedly fell from a tree onto a pointed wooden stave. He was pronounced dead on arrival at hospital. Medico-legal autopsy revealed a penetrating injury traversing the thorax from the left posterolateral chest to the right upper anterolateral chest, with a flat wooden stave found in situ along the wound track. Internal examination demonstrated lacerations of the left lung, pericardium and posterior walls of both ventricles. No additional injuries were identified, and toxicological analysis was negative. Scene investigation confirmed that the wooden stave had been secured to the base of the tree to support a creeping plant and its orientation corresponded with the trajectory of the wound track. The injuries were incompatible with survival and death would have occurred rapidly due to catastrophic cardiac damage. The death was therefore determined to be accidental. This case highlights the importance of correlating autopsy findings with scene investigation when evaluating unusual penetrating injuries associated with falls from a height.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"192-195"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-accidental burns in a neurodevelopmentally vulnerable child: A case of institutional child abuse. 非意外烧伤在神经发育脆弱的儿童：一个案例机构虐待儿童。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-03-17 DOI: 10.1177/00258172261422030

Paranavidana Roshel Claude Wijenayaka, Usliyanage Clifford Priyantha Perera

{"title":"Non-accidental burns in a neurodevelopmentally vulnerable child: A case of institutional child abuse.","authors":"Paranavidana Roshel Claude Wijenayaka, Usliyanage Clifford Priyantha Perera","doi":"10.1177/00258172261422030","DOIUrl":"10.1177/00258172261422030","url":null,"abstract":"Paediatric burns may result from accidental or non-accidental mechanisms, with diagnostic challenges arising when histories suggest dubious accidental causes. We report an 8-year-old boy, placed in a local temple due to longstanding behavioural difficulties, who sustained burns reportedly from hot water spillage. Examination revealed deep burns affecting the left face and neck, lower back, buttocks, perineum and posterior thighs. The distribution and severity were inconsistent with the reported explanation, raising suspicion of non-accidental injury. Multiple facial angiofibromas prompted multidisciplinary assessment, leading to a new diagnosis of tuberous sclerosis, a neurocutaneous disorder associated with cognitive and behavioural impairment. Child protection investigations later identified evidence of abuse within this institutional setting. This case highlights the importance of recognising burn patterns suggestive of non-accidental injury, particularly in children with previously undiagnosed neurodevelopmental disorders, and the critical role of multidisciplinary evaluation and safeguarding in institutional care settings.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"162-165"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fatal firearm injury during peaceful assembly: A forensic case report with human rights implications. 和平集会期间的致命火器伤害：一份具有人权影响的法医案件报告。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-07-10 DOI: 10.1177/00258172261445839

Samjhana Ghimire, Alok Atreya, Salmalee Yadav, Inesh Khanal

引用次数: 0

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-05-04 DOI: 10.1177/00258172261442706

Aaron Olson

引用次数: 0

Fatal ileal perforation following umbilical granuloma excision: A medico-legal case analysis. 脐肉芽肿切除术后致死性回肠穿孔：一例医学-法律案例分析。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-01-18 DOI: 10.1177/00258172251405159

Swati Tyagi, Gokul G, Benjy Tom Varughese, Chittaranjan Behera

{"title":"Fatal ileal perforation following umbilical granuloma excision: A medico-legal case analysis.","authors":"Swati Tyagi, Gokul G, Benjy Tom Varughese, Chittaranjan Behera","doi":"10.1177/00258172251405159","DOIUrl":"10.1177/00258172251405159","url":null,"abstract":"Umbilical granuloma (UG) is a benign and common umbilical anomaly in neonates and infants, typically managed conservatively with salt application or silver nitrate. While rarely requiring surgical intervention, complications arising from invasive treatments are significantly underreported. We present a rare, but fatal case, of bowel perforation following electrocautery excision of a UG in an 11-month-old male infant. The child had a persistent pinkish umbilical lesion unresponsive to conservative treatment. Ultrasonography ruled out underlying vitellointestinal anomalies, and surgical excision was performed under short general anesthaesia. The procedure was uneventful, and the infant was discharged within a few hours postoperatively. Within 24 hours, the child exhibited signs of abdominal distress and was declared dead upon arrival at the emergency department. A medico-legal autopsy revealed haemoperitoneum and a perforation on the antimesenteric border of the ileum. Histopathology demonstrated transmural necrosis at the perforation margins. No other organ pathology or toxicologic cause was identified. The cause of death was certified as haemorrhagic shock secondary to bowel perforation. This case emphasises the need for caution even with routine paediatric procedures, particularly when involving thermal instruments. It underscores the anatomical vulnerability of infants, the critical need for intraoperative precision, extended postoperative observation and protocol-based care. From a legal standpoint, this case raises questions about informed consent, standard of care and institutional liability. The findings highlight the need for national paediatric surgical safety guidelines, especially regarding electrocautery use in superficial procedures and demonstrate the vital role of forensic pathology in uncovering preventable iatrogenic deaths.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"146-149"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refusal of life-sustaining treatment after a suicide attempt in an older adult: Medico-legal and ethical reflections from Greece. 老年人自杀未遂后拒绝维持生命治疗：来自希腊的医学法律和伦理反思。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-03-19 DOI: 10.1177/00258172261419306

Petros Ioannou, Emmanuil Laskaridis, Gerasimia Ntotsika, Symeon Panagiotakis, Diamantis Kofteridis

{"title":"Refusal of life-sustaining treatment after a suicide attempt in an older adult: Medico-legal and ethical reflections from Greece.","authors":"Petros Ioannou, Emmanuil Laskaridis, Gerasimia Ntotsika, Symeon Panagiotakis, Diamantis Kofteridis","doi":"10.1177/00258172261419306","DOIUrl":"10.1177/00258172261419306","url":null,"abstract":"Suicide attempts by older adults can present complex clinical, ethical and legal challenges. While less common than in younger people, they have a higher 'success' rate. When older patients who have attempted suicide subsequently refuse life-sustaining treatment, clinicians must use their medical judgment, have regard for any psychiatric assessment, patient autonomy and local legal frameworks. We report the case of a 93-year-old man admitted to the University Hospital of Heraklion, Greece, who deliberately overdosed on insulin, which resulted in hypoglycaemia and acute-on-chronic kidney injury. Following stabilisation, the patient - whose spouse had recently died and who lived alone - refused haemodialysis. He had full decision-making capacity confirmed by psychiatric evaluation. Conservative management was pursued in collaboration with nephrology, psychiatry and palliative care teams. The patient's renal function gradually improved and he was discharged following recovery. This case underscores the need for a multidisciplinary approach which integrates acute medical care, geriatric assessment and ethical reflection. Respecting the patient's informed refusal of dialysis was consistent with the principles of patient autonomy, beneficence and non-maleficence, and was legally supported under Greek law, which permits passive but not active euthanasia. It illustrates that patient-centred, conservative management can align ethical integrity with clinical prudence, even after a suicide attempt. The case highlights the ethical and legal justification for honouring informed treatment refusal in competent older adults and emphasises the importance of individualised, compassionate care that respects dignity and autonomy at the end of life.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Helium inhalation suicide after-online purchase for birthday party. 网上购买生日派对氦气吸入自杀。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-03-17 DOI: 10.1177/00258172261425374

Mohit Chauhan, Nancy Mittal, Mukta Rani

引用次数: 0