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A Death Resulting from Imperforate Anus in the Newborn: A Case Report.

Young Shik CHOI ; In Seok CHOI ; Tae Jung KWON ; Won Tae LEE

Korean Journal of Legal Medicine.2004;28(2):78-82.

Congenital anomalies of the anus and rectum are relatively common. Minor abnormalities occur in approximately 1 per 500 live births; major anomalies occur in 1 per 5000 live births. Among the various anomalies associated with rectal abnormalities are malformations of the urinary tract and esophagus and, less often, the small bowel. The most useful clinical classification categorized lesions by whether the rectum passes through the puborectalis muscle sling. High lesions fail to pass through this muscle complexes and low lesions traverse this muscle complex. The lesions in the spectrum covered by the term imperforate anus rarely are fatal, although some associated anomalies can be life threatening. However, in some lesions without any type of fistula may be fatal per se, unless the necessary fecal diversion is not made. Routine newborn examinations usually detect anorectal anomalies early in life. Some types of malformations are less readily detected. In newborns, failure to pass meconium within the first 24 hours of life usually prompts an examination of the perineum but delayed presentation is common in areas where access to medical care is unavailable. The authors report a male newborn who died of the high type of anorectal anomaly without fistula in fourth day of life, because the doctor did not recognize the anomaly of the newborn. We believe that the forensic examiner should make medical doctors alert by notifying them that their trivial mistakes can cause mortal results.
Anal Canal ; Anus, Imperforate* ; Classification ; Esophagus ; Fistula ; Humans ; Infant, Newborn* ; Live Birth ; Male ; Meconium ; Perineum ; Rectum ; Urinary Tract

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A Case Study of Death by Bullet with Fired Blank Cartridge.

Young Shik CHOI ; Shin Mong KANG ; Sung Woo PARK ; Jung Pil LEE ; Dong Hwan KIM ; Sung Wook HONG

Korean Journal of Legal Medicine.2004;28(2):70-77.

An university student passed away by an unidentified bullet in a reserve force exercise. An X-ray could not find any bullet from the thorax. The post-mortem examination revealed that the victim had been killed by a 5.56 mm (diameter) bullet. The striation mark of the fatal bullet was coincided with a test fired bullet of a suspect's machine gun. However only blank cartridges had been fired according to the firing range records. Also, the examiner found that the mouth diameter of the fatal blank cartridge case is narrower than the others. In order to explain the strange happening, various situation of blank cartridge firing was considered. The examiner group noticed that the diameter of a blank cartridge mouth fired from an unexpelled bullet including gun may change. The authors test fired a blank cartridge case with a gun including an unexpelled bullet, and compared the shape of the mouth with the fatal blank cartridge case. The mouth shapes of two blank cartridges were coincided. The authors could conclude that the an unidentified suspect charged a bullet in the muzzle of the suspect's gun, and the bullet expelled by the gas pressure of the fatal blank cartridge case.
Autopsy ; Fires* ; Humans ; Mouth ; Thorax

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Fatal Thrombosis of Internal Carotid Artery Following Minor Blunt Trauma to the Neck.

Hyun Jin SON ; Ho LEE

Korean Journal of Legal Medicine.2004;28(2):67-69.

Fatal traumatic thrombosis of the right internal carotid artery occurred in a 37-year-old woman following minor blunt cervical trauma (grasped her neck) during an altercation. An external examination revealed only linear abrasion of right side of neck. The autopsy revealed a thrombosis in the right internal carotid artery and thromboembolism in right middle cerebral arteries. The gross and microscopic findings of the internal carotid artery are presented and the significance of minor cervical blunt trauma and the possible mechanism for the vascular lesion are discussed.
Adult ; Autopsy ; Carotid Artery, Internal* ; Female ; Humans ; Middle Cerebral Artery ; Neck Injuries ; Neck* ; Thromboembolism ; Thrombosis*

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Fatal Carbon Monoxide Poisoning from Incomplete Combustion of Charcoal Briquets: Effect on Public Health of Forensic Medical Expert's Announcement Through the Mass Media.

Sang Yong LEE ; Gi Yeongg HUH ; Kwang Hoon KIM ; Sung Soo EUN ; Sung Jin KIM

Korean Journal of Legal Medicine.2007;31(1):117-120.

Carbon monoxide poisoning is probably one of the most common toxic condition to be met with the routine forensic practice. Carbon monoxide is colorless, odorless, tasteless, non-irritating gas whose relative density is a little less than that of air. The most common source of carbon monoxide in death are fires, automobile exhaust, defected heaters, and incomplete combustion of burning products, such as charcoal briquets. Suicidal deaths caused by carbon monoxide are mostly involve inhalation of automobile exhaust and rarely incomplete combustion of charcoal briquets. We recently experienced three cases of suicidal carbon monoxide death by using the carbon monoxide produced by incomplete combustion of charcoal briquets. These deaths were subsequently occurred after forensic medical expert's announcement of accidental carbon monoxide death occurred at shellfish grill restaurant through the television. And we presents four cases of carbon monoxide death with considering of the social effects of forensic medical expert's announcement through the mass media.
Burns ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Charcoal* ; Fires ; Inhalation ; Mass Media* ; Public Health* ; Restaurants ; Shellfish ; Specific Gravity ; Suicide ; Television ; Vehicle Emissions

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A Case of Tension Pneumoperitoneum as a Fatal Complication of Colonoscopy.

Hoon HUR ; Kyung Moo YANG ; Nak Eun CHUNG ; Shin Mong KANG

Korean Journal of Legal Medicine.2007;31(1):113-116.

Tension pneumoperitoneum (TP) is a rare fatal complication of colonoscopy. In a forensic point of view, this complication is hard to be diagnosed as a cause of death simply considering the result of autopsy findings without clinical information. We experienced an autopsy case expired by TP resulting from colonic perforation during colonoscopy. A 51-year-old woman was performed a colonoscopy under the sedation with propofol. The physician could not find any pathologic lesions throughout the whole colonic mucosa and noticed a perforation at sigmoid colon when he was about to wrap up his procedure. The patient was immediately transferred to the emergency department and showed distended abdomen with unstable vital signs. Although she was taken emergency exploratory laparotomy and simple closure of the perforated site, she died at 3 days after operation due to multiple organ failure. At autopsy, we could not find any other pathologic abnormality except for a wellsutured perforated site. However, the clinical findings and course enabled us to come to conclusion that the cause of death was TP. In conclusion, when conducting an autopsy on the death after colonoscopy, we should consider the possibility of TP by leakage of large amount of air during colonoscopy.
Abdomen ; Autopsy ; Cause of Death ; Colon ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Emergency Service, Hospital ; Female ; Humans ; Laparotomy ; Middle Aged ; Mucous Membrane ; Multiple Organ Failure ; Pneumoperitoneum* ; Propofol ; Vital Signs

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A Death caused by Increased Intraabdominal Pressure due to Spontaneous Intraperitoneal Bladder Rupture.

Hyoung Joong KIM ; Kyung Moo YANG ; Youn Shin KIM ; Tae Jung KWON ; Joong Seok SEO

Korean Journal of Legal Medicine.2007;31(1):108-112.

A 45-year-old female with psychosis complained urological symptom of urinary incontinence and voiding difficulty with abdominal pains and expansion during her psychiatric hospitalization and suddenly collapsed at the 14th day of the admission. At autopsy, the urinary bladder showed a focal perforation and the abdominal cavity was filled with massive urinary ascites. The both lower lobes and the right upper lobe of the lung were accompanied by atelectasis. The death mechanism of this case could be explained that an increased abdominal pressure produced by massive uroperitoneum with spontaneous bladder rupture led to respiratory failure. The so-called abdominal compartment syndrome was manifested by massive uroperitoneum and caused a death. This would be the first forensic medical case that an undiagnosed spontaneous bladder rupture resulted in death of a psychiatric illness patient.
Abdominal Cavity ; Abdominal Pain ; Ascites ; Autopsy ; Female ; Hospitalization ; Humans ; Intra-Abdominal Hypertension ; Lung ; Middle Aged ; Psychotic Disorders ; Pulmonary Atelectasis ; Respiratory Insufficiency ; Rupture* ; Urinary Bladder* ; Urinary Incontinence

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Death due to hydrogen sulfide poisoning after drain cleansing in an apartment house.

Seong Hwan PARK ; Yong ZHANG ; Dong Ha YU ; Hyun Hu JUNG ; Ga Young YOO ; Juck Joon HWANG

Korean Journal of Legal Medicine.2007;31(1):105-107.

A nine-year old boy was found unconscious by his father in his apartment house. He was transferred to the emergency unit immediately but resuscitation was failed. Drain cleansing was performed just before the deceased came home. The father stated that there was foul odor in the house when he opened the door. The autopsy finding showed only nonspecific findings including severe pulmonary edema. Significant amount of sulfide ion was detected from blood and brain tissue. The cause of death was concluded as hydrogen sulfide poisoning.
Autopsy ; Brain ; Cause of Death ; Emergency Service, Hospital ; Fathers ; Humans ; Hydrogen Sulfide* ; Hydrogen* ; Male ; Odors ; Poisoning* ; Pulmonary Edema ; Resuscitation

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Forensic Review of the Medical Accidents Related to the Iatrogenic Injury of Neck Vessels: The report of four autopsy cases.

Seok Hoon JEON ; Nak Eun CHUNG ; Joong Seok SEO

Korean Journal of Legal Medicine.2007;31(1):99-104.

Four cases medical accidents related to the iatrogenic injury of neck vessels are reported. The first case was a 54-year-old woman. Under the diagnosis of the herniated cervical disc, the operation was performed. After five hours from starting the operation, respiratory difficulty, facial cyanosis and syncope were found, suddenly. The autopsy finding were large hematoma at the posterior portion of neck organ and perforation of right carotid artery. The second case was a 61-year-old woman. Under the diagnosis of the aneurysm of the anterior communicating artery, the coiling and embolization were performed. After one hour from removal of catheter of right carotid artery, respiratory difficulty, facial cyanosis and syncope associated with right neck hematoma were found, suddenly. Eventually, she died after 41 days due to hypoxic brain injury. The third case was a 55-year-old woman. Under the diagnosis of the thyroid cancer, total thyroidectomy was performed. After three hours from operation, respiratory difficulty, facial cyanosis and syncope associated with severe neck hematoma were found, suddenly. Eventually, she died after 25 days due to hypoxic brain injury. The last case was a 34-year-old man. He visited the hospital due to stab wound of left neck. The irrigation and simple suture were performed at the first visit. After he went home, respiratory difficulty and syncope were found, suddenly. He returned the hospital and cardiopulmonary resuscitation was performed. However, he died. The autopsy finding were large hematoma around the neck organ and stab wound of left carotid artery.
Adult ; Aneurysm ; Arteries ; Autopsy* ; Brain Injuries ; Cardiopulmonary Resuscitation ; Carotid Arteries ; Catheters ; Cyanosis ; Diagnosis ; Female ; Hematoma ; Humans ; Middle Aged ; Neck* ; Sutures ; Syncope ; Thyroid Neoplasms ; Thyroidectomy ; Wounds, Stab

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Fatal Choking on Food/Foreign Body: 3 autopsy cases.

Youn Shin KIM ; Hoisoon LIM

Korean Journal of Legal Medicine.2007;31(1):95-98.

Choking death means an asphyxiation by blockage of the internal air passages. If it is occurred while eating, it is also called 'Caf? Coronary' syndrome because it seems like acute heart attack due to coronary obstruction. Most chokings are accidental in manners but it may be homicidal although it is relatively uncommon. There is no specific autopsy findings indicative of choking. Therefore autopsy examination should not only attempt to demonstrate airway occlusion by a bolus of food or foreign body, but also to identify underlying risk factors such as an acute intoxication, denture or poor dentition, and neurologic disease. The age range of victims of present cases was 42-59 years old and blood alcohol concentration was in the range of 0.225%-0.32%. The items choked on was a small octopus, a small plastic bottle and a lump of raw meat. The authors describe autopsy findings, including location of obstruction, and risk factors in cases.
Airway Obstruction* ; Autopsy* ; Dentition ; Dentures ; Eating ; Foreign Bodies ; Heart ; Meat ; Octopodiformes ; Plastics ; Risk Factors

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Unexpected Death due to Massive Nontraumatic Intraabdominal Hemorrhage in association with Liver Cirrhosis.

Hyoung Joong KIM ; Yu Hoon KIM ; Nak Eun CHUNG ; Joong Seok SEO

Korean Journal of Legal Medicine.2007;31(1):92-94.

We reports a woman's death caused by massive intraabdominal hemorrhage, who was in chronic alcoholic state with advanced liver cirrhosis and found dead in her room. No macroscopic source for the bleeding was found in her intraabdomen and there was no circumstances of traumatic forces to the individual's body around the death. The presenting unsuspected death could be consistent with the forensic pathological cases described as sudden, unexpected death due to massive nontraumatic intraabdominal hemorrhage in association with liver cirrhosis by DiMaio in 1987.
Alcoholics ; Hemorrhage* ; Humans ; Liver Cirrhosis* ; Liver*

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