Chapter 1 trace evidence from the impacting surface may be. Comparison of injuries and wounds and their classification. Determine height of victim, other contributing factors like heart problems. Furthermore, all cases with knife stab wounds of the skull between 1971 and 2000 were analyzed and compared with literature.
Nevertheless, suicide means do not usually include stab wounds of the arteriovenous access. While stab wounds are typically known to be caused by knives, they can also occur from a variety of implements, including broken bottles and ice picks. Forensic medicine, glasgow university, glasgow, scotland summary. Sharp force injuries should be classified as stab wounds, incised wounds, or chop wounds. If a person breaks the bottle on a table and uses the piece to slash someone, it is an incised wound.
If someone takes the bottle and smashes it over someones head and the skin is opened, that is a laceration. International journal of medical toxicology and forensic. We report a case with lethal stab injury of the brain and identification of the weapon used in the assault by digital superimposition on ct scans taken at admission of the victim to a hospital. Diagnostic value of superficial stab wounds in forensic. Munro bvms, mrcvs, in animal abuse and unlawful killing, 2008. Forensic medicine, glasgow university, glasgow, scotland summary a study was made of patients with stab wounds who attended the accident and. Karlsson 1998 identified defensive injuries in 41% of homicide victims, but not at all in suicides.
Wound is a disruption of the normal tissue structure due to application of force. Importantly, due to the elasticity of tissue, the actual surface length of the stab wound is a poor indicator of the actual width of the instrument that caused it and if. A case is presented in which a 44yearold man stabbed. Wounds from forensic prospectalmumtin, ahmed taher, md 2. There was blood in the abdominal cavity and retroperitoneal region and several perforations were observed in the intestine and liver along the superficial wound. Wound type may vary from bullet, stabbing, blunt force, rape, poisoning considered to be toxicological domain, burn, or traffic fatality. Stab wounds punctured wounds a stab wound is produced by thrusting of any pointed sharp or blunt object into the body so that the depth is the greatest dimension of the wound. The identification and description of wounds may have serious medicolegal implications at a later stage, and often after some considerable time has passed since the wounding. At most, a forensic pathologist will, after thoroughly examining a wound, conclude that a specific knifes i. Forensic medicine by nasib r awan 10 mechanical injuries 4 stab wound explain hesitation cuts and chop wounds define stab wound describe its characteristics and medicolegal significance discuss defense wounds, selfinflicted wounds and injury patterns c lgf dr anwar ul haq 1 hr. Examples are knives, razors, broken glass edge, edge of paper, etc. A major task of a forensic pathologist is to investigate what the wound discloses about how it was inflicted and what inflicted it. Suicide by more than 90 stab wounds including perforation of the skull.
A full treatment of the history of arms development would require volumes, but readers interested in the history of firearms or their function are encouraged to seek more information in the suggested reading sources in the additional resources section. For forensic pathologists, police detectives, and crime scene investigators, dealing with death and injury is a daily routine. By definition a stab wound is deeper than it is long and. An example of a mechanism of death due to a gunshot wound is exsanguination extreme blood loss a old age. What emergency physicians can learn from stab wounds. Sometimes, a traumatic wound may be enlarged and included in the surgical procedure, or a drainage tube may be put in a homicidal stab wound. In non fatal bodily injuries, the study material includes a great variety of constellations such as survived knife attacks. What are the types and important aspects of wound ballistics. Stab wound introduction when the object of forensic investigation is constituted by skeletal remains, obtaining information is more difficult because of the absence of soft tissues.
Hurt hurt is a legal term, which encompasses all the wounds or bodily injuries to a living person. They are generally caused by lowvelocity weapons, meaning the injuries inflicted on a person are typically confined to the path it took internally, instead of causing damage to surrounding tissue, which is common of gunshot wounds. Medicolegal autopsy revealed two abdominal stab wounds near the xiphoid process that had cut the apical pericardium and adjacent diaphragm and liver. Each of the sexual homicides victim sustained a minimum of ten stab wound. The american journal of forensic medicine and pathology. Single edged stab wounds were commonly found in stab wounds. The most common sites of the wounds were the chest 143 patients and the abdomen 1 patients. A stab wound is characterized by an injury that is produced from the penetration of a pointed or sharp object on to the depth of the body where the depth is usually greater than their width. Assessment of stab wound characteristics may assist the forensic practitioner in identifying the type of implement involved, its shape, size, and any possible individual features such as a broken or bent blade tip or anomalous serrations on the blade. Mclay isbn 1900151200 1900151200 softcover, greenwich medical media limited ian miller.
Chapter 1 trace evidence from the impacting surface may. What are proper terms used to describe wound injury patterns. The wound extended to the abdominal aorta, causing retroperitoneal hemorrhage. Examination of the open thorax confirmed that the pericardial sac was distended with air. The length of the wound is measured from one angle to the other. The abdomen is the most commonly injured area from a stab wound. What are some pearls and pitfalls for er physicians when dealing with forensic emergency medicine. The wound is deeper than its length and width on the skin. Expert pathologists from the forensic panel are able to perform wound analysis to reconstruct an event, utilize evidence which may suggest selfdefense, and analyze whether the wound was received peri or postmortem. A case is presented in which a 44yearold man stabbed himself in the heart with a kitchen knife, then changed his bloody clothes, and ate lunch with his aunt, who did not notice the event. Jul 10, 2017 the skin edges of a stab wound are called the wounds margins, and the ends or tips are the wounds angles.
The wound on the trunk is referred to as a reentrant or reentrance wound, and it may be irregular, with characteristics of an atypical firearm wound. The incidence of suicide attempts in people undergoing hemodialysis is well known. The descriptions on stab wounds in most of the current textbooks of forensic pathology,, are limited to those corresponding to typical stab wounds, being stabbed nearly at a right angle or stabbed by forming a considerable angle. Forensic medicine section, university of edinburgh, division of pathology, teviot place, edinburgh eh8 9ag, united kingdom. Multiple stab wounds are very common features of homicidal stabbing. A line drawn between the two angles is the longlongitudinal axis. Forensic pathology, the latest volume in the advanced forensic science series that grew out of the recommendations from the 2009 nas report serves as a graduate level text for those studying and teaching forensic pathology, and is an excellent reference for forensic pathologists libraries or for use in their casework coverage includes postmortem interval, autopsy, trauma, causes of death. S tab wound stab wound is produced when force is delivered along the long axis of a narrow or a pointed object such as knife, dagger, nail, needle, spear, arrow etc. Forensic ballistics a f ir ea rm i s an y instrum e nt w h ic h di sc h a r ge s a miss il e b y m e ex p a n sive fo r ce of th e gases pro du ce d b y humin g of a n ex pl o s i v e s ub sta n ce. Utility of contrastenhanced computed tomography in. Arecord was made of the features and initial management of all patients with stab wounds presenting to the accident and emergency department during the years 1978 and 1983.
The history of gunshot wounds necessarily parallels that of the development of firearms themselves. Forensic interpretation of injurieswounds found on the. Oct 18, 2016 after collecting appropriate trace evidence, taking xrays, and removing clothing, the body should be washed, so that documentation of injuries and photography can take place. Home march 1986 volume 7 issue 1 suicide by selfinflicted stab wound of the chest. International journal of medical toxicology and forensic medicine.
Inflicted stab wounds to neck, chest and abdomen as a unique manner of suicide michal kaliszan m. Forensic pathology of physical injury oxford medicine. Regardless of type, each wound tells experts something about the manner of death. However, external examination is obviously limited in assessing internal injury. In contrast, superficial stab wound is the one, being stabbed nearly parallel to the body surface, namely. A female drug addict who has overdosed on crack cocaine. In addition, weexamined the postmortem reports of25 fatal stab injury. It is important to decide whether the wound is still fresh or whether it shows signs of healing. An elderly woman with deep stab wounds to the neck.
Jun 27, 2019 in cases of inflicted injury, the process of examining the patient for external injuries and documenting the findings is important for forensic assessment, including estimating or determining the type of weapon used and the circumstances of the violence. Examination of the scene of death showed a secure flat, locked from inside. The presentation and circumstantial evidence goes a long way in differentiating the manner of death. A 58yearold male presents to the emergency department in cardiac arrest after sustaining a stab wound to the left neck zone 1. The stab wound is no respecter of anatomical barriers and presents a difficult diagnostic and therapeutic challenge.
A case of suicide with multiple stab wounds selvaraja gr. Dr michael surgrue, trauma service, liverpool hospital stab wounds are incised wounds where the length of injury on the surface is less than the depth of penetration into the body, and are the result of a thrusting action, where the force is delivered along the long axis of a narrow, pointed object. Injury classification 116terms used to describe injuries 118describing injuries 120body diagrams 122bruising 124progression of bruising with time 126lacerations, abrasions, and scratches 128incised wounds stab wounds 2slash wounds 6skin wound healing 8defence injuries 9intimate partner violence and abuse. A major task of a forensic pathologist is to investigate what the wound discloses about how it was inflicted and what. A case of suicide with multiple stab wounds selvaraja gr, jih. Abdominal stab wounds with tension pneumopericardium. A stab wound produced by thrusting of any pointed sharp or blunt object into the body so that the depth is the greatest dimension of the wound.
There was a vertical stab wound on the midline of the victims belly and his intestines were tangled out of the wound. The longitudinal axis can be described as vertical, horizontal, or angled. The margins of a sharp force injury, whether they are stab wounds or incised. Fatal stab wounds to chest are common in homicides as well as suicide. What emergency physicians can learn from stab wounds acep now. Role of the pathologist determine type of wound measure the dimensions length, width, depth position relative to anatomical landmarks determine initial location if wound involves cutting, slashing, etc. It is usually impossible to match a stab wound to a particular knife. Wound is purely a general term having no legal definition. Sharpforce and cuttingedge injuries represent a large group of inflicted injury. Medics have the patient intubated, and two largebore ivs have been initiated with crystalloids infusing. Multiple stab wounds were present on the chest and the abdomen.
An easy way to remember the difference is to think of a glass beer bottle. Suicidal incised wound of a fistula for hemodialysis access. Wounds from forensic prospectalmumtin, ahmed taher, md. A stab wound which runs parallel to the cleavage lines remain slit shaped and narrow a cut which is inflicted across the natural lines of tension tend to gape if the knife is inserted in an oblique plane the skin defect is wider. A study was made of patients with stab wounds who attended the accident and emergency department of glasgow royal infirmary during 1978 and 1983.
Hunt and cowling 1991 found that defence wounds were found in only 15% of those who exhibited a single stab wound, but were seen in 54% of those with multiple stab wounds. Injury by an instrument or a weapon with a sharp cutting edge is known as incised wound. In cases of inflicted injury, the process of examining the patient for external injuries and documenting the findings is important for forensic assessment, including estimating or determining the type of weapon used and the circumstances of the violence. The mechanism of death is the physiological derangement that results in the death. An example of a mechanism of death due to a gunshot wound is exsanguination extreme blood loss. Examples include knives, ice pick, dagger, iron bar, scissors, etc. Stab wounds can cause various internal and external injuries. And the forensic exam is useful in many emergency department contexts. The patient was apneic with a faint pulse at the scene but arrested en route to the emergency department.
Knives, swords, sharpened sticks, screwdrivers, scissors and crossbow bolts are amongst a range of weapons that cause puncture wounds and may. Forensic physicians and pathologists are also asked to examine wounds, whether they are serious or trivial, and whether the injured person is alive or dead. Utility of contrastenhanced computed tomography in forensic. Any sharp or bladed object can cause a range of injuries, in which stab or slashtype injuries are predominant. A stab wound is a specific form of penetrating trauma to the skin that results from a knife or a similar pointed object. For the forensic pathologist, it is usually easier to rule out or eliminate. Digital photography is routinely used within forensic medicine for wound. Nonmissile penetrating brain injuries are rare events in western countries. Ranald munro bvms, msc, dvm, dip forensic medicine, dipecvp, mrcvs, helen m.
Similarly, fragments of skin transferred to the impacting object may be matched to the victim using serology or dna. Stab wounds to the lower chest are associated with abdominal visceral injury in 15%. Stab wounds forensic importance reflects sharp edge, not weapon type no trace evidence. The common findings differentiating homicidal and suicidal stabbing are well described. Herein, a case is presented where a young male was found dead on railway station in suspicious circumstances. Here, we report the cases of two patients who survived stab. Trace evidence from the impacting surface may be present within a graze and can be recovered for identification and matching with the impacting object, for example paint from a vehicle in a hit and run death of a pedestrian. In 503 consecutivehomicides and175cases withlethalstabbinginjuries, intracranial stab wounds 7. Nevertheless, suicide means do not usually include stab wounds.
A twoyearold motor vehicle accident victim with blunt head trauma. Assistant professor, department of forensic medicine, ibn sina medical college, dhaka, bangladesh. If the 2 body parts are in close opposition when the wound is received, both the exit wound and the. Stab wounds are penetrating injuries produced by thrusting an object into the body. One of the main issues in forensic pathology is differen. A very rare case of suicide by stab wound of a fistula for hemodialysis access in an elderly woman is reported. Identify stab wound on model identify penetrating wound identify perforating wound.
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