K L Chng, M M Umul Khairil Fatimah, Z Hafizatul Solehah, H Husna Syaza
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引用次数: 0
摘要
导言:与电击相关的死亡仍然是一个模棱两可的判断,需要大量有效证据才能做出正确的医学-法律诊断。虽然电烧伤痕迹的存在是一个重要的宏观指标,但也可能不存在,尤其是在潮湿的皮肤上。在医学法律领域,电烧伤痕仍然是最基本的指标,但在未来,特别是在不明确的情况下,识别不局限于皮肤的病理要素和迹象可能会起到有效的帮助作用:病例报告:死者是从工作场所被送入医院的,没有致命的自然疾病迹象。外部检查显示,死者颈部右侧有一个 Y 形烧伤疤痕,双脚脚跟处有塌陷性水泡,水泡上有灰白环。内部检查没有发现任何异常。此外,脚部水泡和颈部烧伤的组织病理学分析显示表皮内脱落、细胞核拉长和凝固性坏死。值得注意的是,肾小管中出现肌纤维铸型,肺部切片中出现微血栓,表明存在横纹肌溶解和血管栓塞,这些都证明电击致死与电击有关:结论:这些外部电烧伤痕迹的阳性发现和明显的组织病理学变化,在排除了任何重大致命伤之后,共同支持了电击导致的死亡。尽管如此,对犯罪现场进行详细检查在对触电相关死亡进行分类方面仍起着重要作用。
Rhabdomyolysis and vascular thrombosis supporting the electrocution related death.
Introduction: Electrocution related death remains an ambiguous judgement and requires numerous valid evidence for proper medico-legal diagnosis. While the presence of electrical burn marks is a significant macroscopic indicator, it can be absent, especially on moist skin. The electrical mark still represents a fundamental indicator above all in the medico-legal field, but the identification of pathognomonic elements and signs not limited to the skin alone could be a valid help in the future, especially in unclear cases.
Case report: The deceased was brought-in-dead to the hospital from their workplace, with no signs of fatal natural diseases. External examination revealed a Y-shaped burn mark on the right side of the neck and collapsed blisters with greying rings on both heels. Internal examination showed no alarming findings. Further, histopathological analysis of the foot blisters and neck burn revealed intraepidermal detachment, elongated nuclei, and coagulative necrosis. Notably, the presence of muscle fibre casts in kidney tubules and microthrombi in lung sections which indicate rhabdomyolysis and vascular thrombosis supported electrocution-related death.
Conclusion: These positive findings of the electrical burn marks externally and significant histopathological changes, collectively support the death was due to electrocution, after excluding any major, fatal injuries. Albeit, a detailed inspection of the crime scene plays an important role, in order to classify the electrocution related death.
期刊介绍:
The Malaysian Journal of Pathology is the official journal of the College of Pathologists, Academy of Medicine Malaysia. The primary purpose of The Journal is to publish the results of study and research in Pathology, especially those that have particular relevance to human disease occurring in Malaysia and other countries in this region. The term PATHOLOGY will be interpreted in its broadest sense to include Chemical Pathology, Cytology, Experimental Pathology, Forensic Pathology, Haematology, Histopathology, Immunology, Medical Microbiology and Parasitology. The Journal aims to bring under one cover publications of regional interest embracing the various sub-specialities of Pathology. It is expected that the articles published would be of value not only to pathologists, but also to medical practitioners in search of a scientific basis for the problems encountered in their practice, and to those with an interest in diseases which occur in the tropics.