[Forensic autopsy cases of battered children in Japan (1990-1999)].

The investigation committee of Japanese Society of Legal Medicine has investigated 459 forensic autopsy cases of battered children from 1990-1999. The age range was 0-4 years of 381 cases (83%). Of them, the age less than 1 year was high as 161 cases (35.1%). The cause of death including head injury was 161 cases (35.1%), suffocation caused by nasal blockages 37 cases (8.1%), strangulation 32 cases (7.0%), and drowning 30 cases (6.5%) was revealed. In case of assailant, own mother was 226 cases (49.2%), own father was 73 cases (15.9%) and stepfather 46 cases (10.0%) were reported. The intention of cruelty was that the body was positively assaulted (84.3%) and duration was less than 2 months in 136 cases (67%). The nature of cruelty was that beating by other hands (16.8%) in 77 cases and pushed away and threw (1.7%) in 8 cases and those complex (7.8%) in 36 cases. The motive of cruelty when he assailant was own mother (209 cases) was as fellow: 1. Mentally abnormal (15.3%), 2. Irresponsibility (14.4%), 3. Victim cries (5.7%). When the assailant was own father (63%), the motive of cruelty was as 1. Victim cries (12.7%), 2. Lack of love (7.9%), 3. Reassisted attitude (6.3%). Reported death in high temperature was in 29 cases (6.3%) and strangulation was in 27 cases (5.9%). The homicide was 13% and neither care nor protection (neglect) was 2.7%. The physical conditions of battered children were emaciated and stunted growth in 128 cases (31.2%). The past history of medical consultation to the medical hospital was 32 cases (17.8%). Among the injuries, external findings consist of abrasions and bruises were 147 cases (32%) and internal findings were 70 cases (16.7%) mainly numerous gastro-intestinal tract injuries than liver and lungs. In addition, lung edema (16.8%) in 68 cases, thymus atrophy (12.6%) in 51 cases and amalgamation (4.5%) in 18 cases were reported. The injury around the anus and genitalia were 13 cases (3.2%). The bone fracture was not observed in 368 cases (80.2%) out of 459. Among the intracranial injuries, subdural haemastoma or amalgamation were 31.6% (145 cases) out of 459.