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Am J Forensic Med Pathol 2020 Jun 30. Epub 2020 Jun 30.

From the Department of Pathology, University of New Mexico.

Acute pancreatitis is uncommon in children and adolescents, and when it does occur, it is rarely fatal. The cause of death may be misdiagnosed as a death due to diabetic ketoacidosis or an infectious disease if an autopsy is not performed. Because these deaths are often unexpected and may occur before medical care, the forensic pathologist may be contacted to determine the cause of death. Read More

Am J Forensic Med Pathol 2020 Jun 30. Epub 2020 Jun 30.

From the Hungarian Institute for Forensic Sciences, Regional Institute, Regional Institute, Miskolc.

A 17-year-old prisoner was found unconscious during a morning check. The previous night, he had been struck on the chin multiple times by one of the other inmates. The patient remained unconscious and eventually died after nearly 1. Read More

Am J Forensic Med Pathol 2020 Jun 30. Epub 2020 Jun 30.

Sudden Infant Death Syndrome Liguria Centre, Department of Pediatric Emergency, Istituto Giannina Gaslini, Genova, Italy.

Acute bacterial meningitis in infants and newborns represents a medical emergency and a significant cause of mortality and morbidity worldwide. Moraxella catarrhalis has been considered a microorganism with low pathogenic potential, and only in exceptional cases has it been found to cause meningitis in infants and immunocompetent people. We will now document an unusual case of an unexpected and sudden death of a 40-day-old infant due to acute meningitis from M. Read More

Am J Forensic Med Pathol 2020 Jun 30. Epub 2020 Jun 30.

From the Department of Pathology.

The use of postmortem computed tomography (PMCT) to support autopsy pathology has increased in recent decades. To some extent, PMCT has also been contemplated as a potential alternative to conventional postmortem examination. The purpose of this study was to investigate the ability of PMCT to detect specific pathologic findings in the head and brain in natural hospital deaths. Read More

Am J Forensic Med Pathol 2020 Jun 26. Epub 2020 Jun 26.

Department of Health Surveillance and Bioethics Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy Department of Health Surveillance and Bioethics Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy Department of Radiology Fondazione Policlinico A. Gemelli, IRCCS Department of Health Surveillance and Bioethics Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy.

Am J Forensic Med Pathol 2020 Jun 26. Epub 2020 Jun 26.

Department of Pedodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey.

This retrospective study aimed to measure the antegonial angle (AGA) and antegonial depth (AGD) on panoramic radiographs in a Turkish subpopulation and to determine how those measurements relate to sex before puberty. A total of 600 patients were divided into 3 age groups (5, 6, or 7 years), and each group consists of 100 boys and 100 girls. For each patient, AGA and AGD indices in panoramic radiograph were measured by an oral radiologist and pediatric dentist. Read More

Am J Forensic Med Pathol 2020 Jun 26. Epub 2020 Jun 26.

From the University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND.

Am J Forensic Med Pathol 2020 Jun 18. Epub 2020 Jun 18.

Department of Pathology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND.

A 53-year-old man was found to have a giant 16 × 6-cm hemorrhagic and cystic mass centered on the pancreas and duodenum. Initially diagnosed as a pancreatic pseudocyst at the time of autopsy, the cystic mass was later determined by histologic examination to be a true diverticulum of the duodenum as microscopic examination of the wall revealed 2 layers of muscle, as well as a neutrophilic infiltrate. While the cause of death of the individual was certified as methamphetamine toxicity, cardiomegaly and probable dehydration associated with a giant duodenal diverticulum were listed as contributory conditions. Read More

Am J Forensic Med Pathol 2020 Jun 18. Epub 2020 Jun 18.

Institute of Clinical Pathology, Medical College of Shantou University, Shantou, Guangdong Province, China.

Anaphylaxis is a serious reaction that may cause death in half an hour without diagnostic characteristic in autopsies. Mast cell (MC) degranulation combined with immunoglobulin E (IgE) plays the key roles in anaphylaxis. Unavailability of serum and instability of measured serum in postmortem diagnoses sometimes limit the opinion of medical experts. Read More

Am J Forensic Med Pathol 2020 Jun 20. Epub 2020 Jun 20.

Wayne County Medical Examiner's Office, Michigan Medicine/University of Michigan.

Undiagnosed significant hydrocephalus is an uncommon finding at forensic autopsy as many cases present in life with complex neurological symptoms. We present a case of a 46-year-old man with no neurological deficits or history of head trauma that was incidentally found to have a massive hydrocephalus at autopsy. This was found to be associated with an unruptured arteriovenous malformation completely confined to the choroid plexus as well as complete agenesis of the corpus callosum. Read More

Am J Forensic Med Pathol 2020 Jun 12. Epub 2020 Jun 12.

From the Department of Forensic Medicine, Ibn El Jazzar University Hospital, Kairouan.

High-voltage electrocution is mostly unintentional, and it is associated with significant morbidity and mortality due to severe tissue damages. The present report describes an atypical electrocution with multiple victims and a fatal outcome of a 48-year-old man due to unusual neck injuries caused by accidental electrical burns. Read More

Am J Forensic Med Pathol 2020 Jun 12. Epub 2020 Jun 12.

From the Department of Legal and Forensic Medicine, University of Genova, Genova.

Acute myeloid leukemia (AML) is characterized by the rapid growth of abnormal white blood cells in the bone marrow that interferes with the production of normal blood cells. This disease is burdened by a high risk of bleeding complications involving central nervous system hemorrhages, purpura, gingival bleeding, and gastrointestinal bleeding. In this article, the authors report a case of a fatal intracerebral hemorrhage in a 21-year-old man who was affected by an undiagnosed AML. Read More

Am J Forensic Med Pathol 2020 Jun 12. Epub 2020 Jun 12.

From the Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

The rupture of spleen is common in clinical and forensic practice. Trauma is the most common cause of splenic rupture. Although rare, traumatic splenic rupture may occur in these individuals with asymptomatic underlying disease, and clinical and forensic pathologists may neglect the disease and diagnose only the traumatic splenic rupture. Read More

Am J Forensic Med Pathol 2020 Jun 3. Epub 2020 Jun 3.

Forensic Sciences Department, Chennai, India.

Household cleaners are an unavoidable entity in our routine domestic life. They are available either in company-labeled bottles or locally made unlabeled bottles especially in the developing countries. In this report, we are discussing a case of fatal ingestion of household cleaner, which was stored in an unlabeled bottle. Read More

Am J Forensic Med Pathol 2020 Jun 3. Epub 2020 Jun 3.

From the Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland.

Heart weight is routinely measured at postmortem examination and is critical to determine whether the heart is enlarged (ie, cardiomegaly). Cardiomegaly has the potential to cause sudden death by being electrically unstable, resulting in fatal arrhythmias. The majority of fatal cardiac arrhythmias is ventricular in origin and is assumed that ventricular size is disproportionately larger in cardiomegaly. Read More

Am J Forensic Med Pathol 2020 May 12. Epub 2020 May 12.

Laboratory Quality Assurance and Proficiency Program, RTI International, Research Triangle Park, NC.

The National Association of Medical Examiners convened an expert panel to update the association's evidence-based recommendations for investigating and certifying deaths associated with opioids and other misused substances to improve death certificate and mortality data for public health surveillance. The recommendations are as follows:1. Autopsy provides the best information on a decedent's medical condition for optimal interpretation of toxicology results, circumstances surrounding death, medical history, and scene findings. Read More

Am J Forensic Med Pathol 2020 06;41(2):141

Institute of Forensic and Traffic Medicine, Heidelberg University, Heidelberg, Germany, Gokyuzu OSGB Lmt, Kahramanmaraş, Turkey.

Am J Forensic Med Pathol 2020 Jun;41(2):138-140

From the Departments of Forensic Medicine and Laboratory of Research LR12SP14.

Cavernous hemangiomas represent the most common benign tumors affecting the liver. They are more often asymptomatic and usually diagnosed through radiological examinations performed for other reasons. When there are symptomatic, they may cause digestive disorders such as abdominal pain, nausea, vomiting, or a palpable mass. Read More

Am J Forensic Med Pathol 2020 Jun;41(2):135-137

From the Department of Forensic Medicine, Wrocław Medical University, Wrocław, Poland.

The authors report on a case of a 43-year-old male pedestrian struck and run over by a truck. The accident was accompanied by a mechanism of injury resulting in a unique autopsy picture of trunk and head injuries. The internal organs of the neck (larynx, trachea, esophagus), chest (lungs, thoracic aorta), and part of the abdominal cavity (bottom of the stomach and fragments of the liver) were dislocated in the direction of the head. Read More

Am J Forensic Med Pathol 2020 Jun;41(2):131-134

From the School of Forensic Medicine.

The patient was an 88-year-old woman with a 10-year history of hypertension. She was suspected to have been hit by a car. At the time of the event, she was conscious and able to stand on her own and had no obvious injuries. Read More

Am J Forensic Med Pathol 2020 Jun;41(2):128-130

From the Departments of Forensic Medicine and Laboratory of Research LR12SP14.

Epidermoid cyst of the brain is a rare benign embryonal tumor. It has an excellent prognosis because of its slow-growing nature. Clinically, symptoms are variable and depend on the location of the cyst. Read More

Am J Forensic Med Pathol 2020 Jun;41(2):104-109

Department of Forensic Medicine, Faculty of Medicine, Ataturk University.

Drowning is one of the major causes of unintentional injury death worldwide. As there are no pathomorphological findings specific to the diagnosis of drowning, definitive postmortem diagnosis of drowning continues to be a significant problem in forensic medicine. This study aims to present an additional diagnostic sign in cases of freshwater drowning by investigating the histopathological changes of renal tissue in the postmortem diagnosis of freshwater drowning. Read More

Am J Forensic Med Pathol 2020 06;41(2):85-89

From the Florida District 7 DME, Volusia County, FL.

Am J Forensic Med Pathol 2020 Jun 5. Epub 2020 Jun 5.

Chief Medical Examiner, Snohomish County Medical Examiner's Office, 9509 29th Ave W, Everett, WA 98204 Associate Professor of Pathology, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Madison, WI 53792 National Association of Medical Examiners (NAME) Ad-hoc Bioterrorism and Infectious Disease Committee Members.

As a result of the 2019 novel human coronavirus (COVID-19) global spread, medical examiner/coroner offices will inevitably encounter increased numbers of COVID-19-infected decedents at autopsy. While in some cases a history of fever and/or respiratory distress (e.g. Read More

Am J Forensic Med Pathol 2020 Apr 24. Epub 2020 Apr 24.

University of Texas Health San Antonio.

Am J Forensic Med Pathol 2020 Jun;41(2):119-123

From the Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich.

The use of postmortem computed tomography (CT) has been described in many articles concerning gunshot injuries. Postmortem magnetic resonance imaging (MRI) for better assessment of soft tissue injuries has also been mentioned in the literature, albeit much less often. The use of postmortem MRI for abdominal gunshot wounds has not been previously presented in the literature. Read More

Am J Forensic Med Pathol 2020 Jun;41(2):97-103

From the Department of Forensic Medicine and Imaging, University of Zurich.

Purpose: The aim of this study was to evaluate magnetic resonance imaging (MRI) findings in cases of fatal manual or ligature strangulation. Verification of strangulation by computed tomography (CT), MRI, and at autopsy as well as its detectability in each modality was assessed.

Methods: We retrospectively analyzed 6 manual and ligature strangulation cases between 2013 and 2019 who all underwent a whole-body CT, head and neck MRI, and an autopsy. Read More

Am J Forensic Med Pathol 2020 Jun;41(2):110-114

From the Forensic Unit, Department of Pathology.

Organ weights are routinely measured during autopsies as a crude screening tool to detect possible organ pathology. In several centers, inclusion of major organ weights indicates whether an autopsy report has achieved its standard of practice, which in turn should be subjected to an audit. Previous studies show statistical variation in organ weights across different populations. Read More

Am J Forensic Med Pathol 2020 Jun;41(2):115-118

From the Chettinad Dental College and Research Institute, Kelambakkam, India.

Objectives: This study was carried out to correlate chronological age of the patients with dental age using to Demirjian's method and to evaluate if orthopantamogram examination of third molar development correlates with age estimation.

Study Design: The study was designed as a radiological cross sectional study. Simple random sampling method was used to obtain study subjects. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):5-10

Department of Forensic Science, Seattle University, Seattle, WA.

Use of excessive force (UOEF) is an important and controversial topic but little is known about how injury severity is related to allegations of UOEF. We hypothesized that such complaints would be associated with more significant traumatic injuries. Emergency department records were searched for all individuals making UOEF complaints against an urban police department from 2010 to 2012. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):42-47

From the Herbert Wertheim College of Medicine, Florida International University, Miami.

Myocardial steatosis, also known as lipomatosis cordis, is characterized by adipose tissue within the myocardium without significant fibrosis. Evidence suggests that accumulation of fat can disturb the normal electromechanical physiology of the myocardium. Herein, we discuss the case of a 60-year-old woman with a history of chronic obstructive pulmonary disease who died because of anoxic encephalopathy after a sudden cardiac arrest (SCA). Read More

Am J Forensic Med Pathol 2020 Mar;41(1):32-34

From the Department of Forensic Medicine, Linköping and Linköping University, Linköping, Sweden.

Thymus glands from 283 autopsy cases were sampled and evaluated with histochemical and immunohistochemical methods. A subpopulation of 41 intravenous drug addicts were compared with age-matched control cases.It was found that an accelerated involution of the thymus occurred in the 20- to 25-year interval and thereafter with a steady pace of 5% per year. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):1-4

Peoria County Coroner's Office, Peoria, IL.

The popularity of e-cigarettes (vaping) has been on the rise in recent years, but the adverse effects of vaping have been greatly unknown. In 2019, the use of vaping products has been linked to an outbreak of severe lung disease, some cases of which have progressed to death. One death attributed to vaping is presented with emphasis on the gross and histopathological findings from the autopsy. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):60-63

From the Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita.

Postmortem computed tomography (PMCT) is used commonly in forensic medicine. Postmortem computed tomography of the head provides information on the eyes and orbits and may reveal intraocular abnormalities. We present a case in which the identity of a deceased man was confirmed by the presence of aphakic eyes detected on PMCT. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):11-17

Alberta Office of the Chief Medical Examiner, Edmonton, Alberta, Canada.

Errors in death certification can directly affect the decedent's survivors and the public register. We assessed the effectiveness of an educational seminar targeting frequent and important errors identified by local death certificate (DC) evaluation. Retrospective review of 1500 DCs categorized errors and physician specialty. Read More

Am J Forensic Med Pathol 2020 03;41(1):81

Roberval, Québec, Canada

Am J Forensic Med Pathol 2020 Mar;41(1):48-51

Department of Medical Examiner-Coroner, Los Angeles.

Chikungunya is a mosquito-transmitted viral illness with clinical hallmarks of rash, fever, arthralgia, and myalgia. It is rarely fatal, although vulnerable populations, to include elderly, children, and those with multiple comorbid illnesses, are more susceptible to severe infection and death. There have been multiple areas of the world with periodic chikungunya epidemics. Read More

Am J Forensic Med Pathol 2020 03;41(1):81-82

University of Minnesota, Minneapolis, MN; and California Polytechnic State University, San Luis Obispo, CA LAAW International, LLC, Scottsdale, AZ Plymouth Police Department, Plymouth, MN Independent consultant, Edina, MN Valdosta State University, Valdosta, GA Consultant Cardiac Pathologist, Berkeley, CA.

Am J Forensic Med Pathol 2020 Mar;41(1):56-59

From the Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto.

Postmortem personal identification in forensic science is performed using various methods. However, severely burnt bodies are hard to identify using odontological or skeletal features because of carbonization, and sometimes DNA profiling is impracticable because of the unavailability of the relatives. We present a case of a burn victim found after a house fire. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):40-41

From the Division of Legal Medicine, Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine.

The deceased was a 44-year-old male who was treated for a suspected Ebstein's anomaly observed using transthoracic echocardiogram. He was found dead in his bed at home. Autopsy revealed that the septal tricuspid leaflet was intact; however, a large anterior tricuspid leaflet cleft and right atrioventricular cavity dilation were observed. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):52-55

Department of Pathology and Laboratory Medicine, London Health Sciences Centre and Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Characteristic injury patterns have been described in pedestrians struck by motor vehicles. The common injury pattern seen in upright pedestrians consists of a triad of head, pelvis, and lower extremity trauma. There are several factors such as vehicular type, design, mass and speed, and impact surfaces that influence the type and distribution of these injuries. Read More

Am J Forensic Med Pathol 2020 Mar;41(1):27-31

Section of Legal Medicine, University of Macerata, Macerata.

Background: The incidence of taking selfies and sharing them on social media as well as selfie-related dangerous behaviors is increasing, particularly among young people, also leading to selfie-related trauma and death. This study was performed to obtain epidemiological characteristics of selfie-related mortality in Italy.

Methods: Scientific literature and Italian media were reviewed. Read More