This article describes a method of introducing postmortem CT angiography into daily forensic medicine practice involving cases of limb stab wounds investigated at the Department of Forensic Medicine, University Hospital Ostrava. The essential preparation of the vessels as well as practical tips facilitating the subsequent performance of a classic autopsy are described in detail. Article also includes brief review of published papers dealing with PMCT angiography related issues, advantages which brings CT angiography into forensic routine work, but also its limits and pitfalls.

• Klíčová slova
• Autopsy, forensic medicine, forensic pathology, forensic radiology, postmortem CT angiography, research, sharp force injuries,
• MeSH
• bodné rány * diagnostické zobrazování   MeSH
• CT angiografie * MeSH
• lidé MeSH
• pitva * metody   MeSH
• soudní lékařství metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

This paper presents a retrospective review of patterns found in cases of homicides by sharp force over a 13-year period at the Department of Forensic Pathology of the Ostrava University Hospital, Czech Republic. The review summarizes all frequently discussed aspects of such cases including the number and localization of injuries, the presence of defensive wounds, the type of the offending weapon, the cause of death, the place of death, victims' and perpetrators' profiles, their relationship, or toxicological findings. Furthermore, special attention was paid to the evaluation of any accompanying blunt force trauma that may be indicative of an escalation of the assault. The set of data was statistically analyzed. Even though most of the results of this review are consistent with available published studies, noteworthy differences have emerged in some aspects such as the sex and age of the victims, the relationship between the number of injuries suffered and the victims' sex, or the severity of alcohol intoxication in victims.

• Klíčová slova
• Assault escalation, Blunt force trauma, Defensive wounds, Homicide, Sharp force trauma,
• MeSH
• lidé MeSH
• oběti zločinu * MeSH
• otrava alkoholem * MeSH
• retrospektivní studie MeSH
• soudní patologie MeSH
• tupá poranění * patologie   MeSH
• vražda MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

This paper deals with a fatal stab wound suffered by a 29-year-old man and nonfatal injuries of 35-year-old and 67-year-old saw operators. Rip saw is a machine that is specially designed for making a rip cut, a cut made parallel to the direction of the wood grain. Rip-saw-related injuries mostly occur when a person is struck by the cutting material, which usually involves splinters of irregular shape and diameter. When the splinter strikes the body diagonally, the injuries may include abrasions, lacerations, and cut wounds; in situations where the victim is struck directly, the most common injuries are oval- or star-shaped stab wounds with a varying width of abrasions around the wounds. Therefore, such injuries may come across as injuries produced by a knife-like instrument, which is an added difficulty in the interpretation of such injuries.

• Klíčová slova
• accidental death, forensic pathology, homicide, rip saw, sharp force injuries, stab wounds, suicide,
• MeSH
• bodné rány patologie   MeSH
• dospělí MeSH
• fibula diagnostické zobrazování   zranění   MeSH
• fraktury tibie diagnostické zobrazování   etiologie   MeSH
• lidé MeSH
• počítačová rentgenová tomografie MeSH
• poranění hrudníku patologie   MeSH
• poranění ruky etiologie   patologie   MeSH
• poranění srdce patologie   MeSH
• pracovní nehody * MeSH
• senioři MeSH
• tříštivé fraktury diagnostické zobrazování   etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Sharp force injuries are uncommon in routine forensic practice. While the majority of these cases are homicides or suicides, a significant minority of accidental deaths means that a careful investigation of the circumstances of the death is necessary. We present the case of a young man who presented with stab and cut injuries due to a duralumin rod embedded in his chest. Examination of the body revealed that death was due to penetration of the thoracic aorta by a duralumin rod. Careful investigation of the circumstances surrounding the death was able to confim a case of accidental death due to falling from a ladder onto tomato seedlings that were supported by duralumin rods.

• Klíčová slova
• Accidental death, Homicide, Sharp force injuries, Stab wounds, Suicide,
• MeSH
• aorta thoracica zranění   patologie   MeSH
• bodné rány patologie   MeSH
• fatální výsledek MeSH
• lidé MeSH
• mladý dospělý MeSH
• úrazy pádem MeSH
• úrazy v domácnosti MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

This case report deals with a sharp force suicide case, which may challenge the experience of many forensic pathologists as well as the studies published to date. An overview of the published cases shows that sharp force suicides account only for 1.6%-3% of all suicides and the self-inflicted injuries are usually localized on the body parts easily accessible with one's hand including the neck, thorax, or upper extremities, as well as in locations of major vascular bundles or vital organs. Reported, however, is a case in which the victim relied on the knowledge of her medical condition and used a kitchen knife to incise her varicose veins, which resulted in fatal bleeding. The case is rare on a number of grounds: incision of varicose veins is rarely the method of choice in suicide cases, injuries of peripheral veins are rarely fatal, and so are injuries of isolated veins where no damage to arteries is suffered.

• Klíčová slova
• autopsy, fatal hemorrhage, forensic pathology, incised wounds, sharp force fatality, suicide, varicose veins,
• MeSH
• dokonaná sebevražda * MeSH
• exsanguinace etiologie   MeSH
• lidé MeSH
• senioři MeSH
• varixy * MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

While assessing skeletal injuries in human skeletal remains, forensic anthropologists are frequently presented with fractured, fragmented, or otherwise modified skeletal remains. The examination of evidence and the mechanisms of skeletal injuries often require that separate osseous elements be permanently or temporarily reassembled or reconstructed. If not dealt with properly, such reconstructions may impede accurate interpretation of the evidence. Nowadays, routine forensic examinations increasingly incorporate digital imaging technologies. As a result, a variety of PC-assisted imaging techniques, collectively referred to as the virtual approach, have been made available to treat fragmentary skeletal remains. The present study employs a 3D virtual approach to assess mechanisms of skeletal injuries, and provides an expert opinion of causative tools in three forensic cases involving human skeletal remains where integrity was compromised by multiple peri- or postmortem alterations resulting in fragmentation and/or incompleteness. Three fragmentary skulls and an incomplete set of foot bones with evidence of perimortem fractures (gunshot wounds) and sharp force trauma (saw marks) were digitized using a desktop laser scanner. The digitized skeletal elements were reassembled in the virtual workspace using functionalities incorporated in AMIRA® version 5.0 software, and simultaneously in real physical space by traditional reconstructive approaches. For this study, the original skeletal fragments were substituted by replicas built by 3D printing. Inter-method differences were quantified by mesh-based comparison after the physically reassembled elements had been re-digitized. Observed differences were further reinforced by visualizing local variations using colormaps and other advanced 3D visualization techniques. In addition, intra-operator and inter-operator error was computed. The results demonstrate that the importance of incorporating the virtual approach into the assessment of skeletal injuries increases with the complexity and state of preservation of a forensic case. While in relatively simple cases the virtual approach is a welcome extension to a traditional approach, which merely facilitates the analysis, in more complex and extensively fragmentary cases such as multiple gunshot wounds or dismemberment, the virtual approach can be a crucial step in applying the principles of gunshot wounds or sharp force traumatic mechanisms. The unrestricted manipulation with digital elements enabling limitless repairs and adjustments to a "best-case scenario" also produced smaller inter-operator variation in comparison to the traditional approach.

• Klíčová slova
• 3D printing, Perimortem skeletal injuries, Reassembly, Virtual approach,
• MeSH
• 3D tisk MeSH
• dospělí MeSH
• fraktury kostí patologie   MeSH
• fraktury lebky patologie   MeSH
• kosti nohy (od hlezna dolů) zranění   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• penetrující rány patologie   MeSH
• počítačová simulace * MeSH
• počítačové zpracování obrazu * MeSH
• soudní antropologie metody   MeSH
• střelné rány patologie   MeSH
• zobrazování trojrozměrné MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Iatrogenic injuries to blood vessels in joint replacement surgery are rare events that occur as few per thousand. However, their sequelae are serious. The patient may either bleed to death, because vascular injury is not obvious and therefore difficult to diagnose, or lose the limb due to ischaemia. The highest risk of vascular injury is associated with repeat surgery and loosening of the acetabular component. We distinguish sharp and blunt force injuries. The former are caused by implants, sharp instruments, bone fragments or bone cement debris. The latter arise from stretching over a part of implanted material. Bleeding can be inapparent or apparent. Inapparent bleeding is difficult to diagnose and is recognized from the dynamics of blood losses. Haemodynamic instability or, in a worse case, even hypovolaemic shock may be the only signs of bleeding. Occlusion of an artery is manifested by limb ischaemia. The seriousness and progression of ischaemia depends on the rate of arterial occlusion, potential pathways for collateral circulation and the degree of atherosclerotic vascular disease. The patient with conduction anaesthesia does not feel pain and therefore the diagnosis must primarily be based on arterial pulsation in the limb and its skin colour. A pseudoaneurysm can develop due to a partially weakened vascular wall and its rupture is a life-threatening complication. Its presence is recognized as a pulsating mass in the groin. An arterio- venous fistula which arises from traumatic communication between the two vessels may lead to cardiac failure. The diagnosis is based on examination by sonography and digital subtraction angiography. The results of CT angiography and MR angiography are difficult to evaluate because of the presence of metal implants. In apparent bleeding it is sometimes difficult to locate the source. It is recommended to perform digital compression and gain access to the vessels from the extraperitoneal approach. When an expanding haematoma or ischaemia is present, the artery can be treated by surgical exploration or percutaneous transluminal angioplasty. A possibility of vascular injury should be taken into account particularly in revision arthroplasty. To check blood flow in the limb before surgery is advisable. If the procedure entails a significant risk of post-operative complications, a vascular surgeon should be available. In the case of acute intra-operative bleeding, the source should be localised as soon as possible, the site compressed and an expert assistance called in. When the source is not obvious, it should not be attempted to apply vascular clamps or clips at random; this may do even more damage to the vessel.

• MeSH
• arteriovenózní píštěl diagnóza   etiologie   terapie   MeSH
• bérec krevní zásobení   MeSH
• hematom etiologie   terapie   MeSH
• ischemie diagnóza   etiologie   terapie   MeSH
• kompartment syndrom diagnóza   etiologie   terapie   MeSH
• krvácení diagnóza   etiologie   terapie   MeSH
• lidé MeSH
• náhrada kyčelního kloubu škodlivé účinky   MeSH
• nepravé aneurysma diagnóza   etiologie   terapie   MeSH
• poranění cév diagnóza   etiologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Sharp weapons have been one of the most common deadly tools in cases of homicide and suicide for a long time. Tentative incisions accompany the majority of suicides by sharp force and the absence of hesitation marks provokes questions about the manner of death. We present the bizarre fatality of a 41-year-old male with an isolated circumscribed incision on the right neck, where the body was found lying in a pool of blood in the shower of his apartment. The internal examination revealed a 4-cm-long channel-like defect running inwardly and downwardly along the right sternocleidomastoid region. The cause of death was external bleeding from an injured right carotid artery and internal jugular vein. The wound had clean non-contused margins without any conspicuous hesitation injuries. A fragment of a razor blade, found in blood splatters, was identified as the only potential injuring tool. The case was classified as a suicide.

Ostre przedmioty od dawna należą do narzędzi najczęściej wykorzystywanych w zabójstwach i samobójstwach. W większości przypadków samobójstw z użyciem ostrego narzędzia stwierdza się powierzchowne nacięcia próbne, a brak takich śladów zawahania może budzić wątpliwości odnośnie do rodzaju śmierci. W niniejszej pracy zaprezentowano niecodzienny przypadek zgonu 41-letniego mężczyzny, u którego stwierdzono pojedyncze ograniczone nacięcie zlokalizowane po prawej stronie szyi. Ciało ujawniono w kałuży krwi w kabinie prysznicowej w mieszkaniu denata. Badanie wewnętrzne wykazało kanałowy ubytek o długości 4 cm, przebiegający do wewnątrz i do dołu wzdłuż mięś­nia mostkowo-obojczykowo-sutkowego po prawej stronie. Przyczyną zgonu był krwotok zewnętrzny z uszkodzonej prawej tętnicy szyjnej i żyły szyjnej wewnętrznej. Brzegi rany były gładkie, nieotarte, pozbawione widocznych urazów wskazujących na zawahanie. W rozpryskach krwi zmarłego ujawniono fragment żyletki. Stwierdzono, że jest to jedyne narzędzie, jakie mogło zostać wykorzystane do zadania rany. Zgon w omawianym przypadku został uznany za samobójstwo.

• Klíčová slova
• hesitation marks, razor blade, ritual suicide, stab wound, autopsy,
• MeSH
• bodné rány patologie   MeSH
• dospělí MeSH
• lidé MeSH
• poranění cév patologie   MeSH
• poranění krku patologie   MeSH
• příčina smrti MeSH
• rituální chování MeSH
• sebepoškozování * MeSH
• sebevražda * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The experiences gained from the medicolegal investigation of murdered 34 women an 32 men are being dealt with. In the causes of death prevailed the combined injuries, followed by the blunt force injuries, asphyxia, injuries by gunfire and sharp force injuries. In the majority of cases the offenders are men up to the age of 30. The investigation covered the laboratory examination of the clothes of the victims and offenders, biological stains, histology and hairs. 22% of the victims and 60% of the offenders were under the influence of alcohol at the time of homicide. Drugs were found in 19% of the victims and 20% of the offenders. The medicolegal investigation of homicide requires further and improved methods especially in the examination of biological stains.

• MeSH
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• rány a poranění MeSH
• senioři MeSH
• soudní lékařství * MeSH
• vražda * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH

Fatalities attributed to powered circular saws appear to be vanishingly rare events with highly wounding and rapidly incapacitating effects. When they do occur, they are mainly self-inflicted in nature. We report the suicide committed by a 79-year-old man using a self-made circular table saw. Autopsy confirmed that the man received multiple heterogeneously distributed saw-type impacts to the head and neck resulting in complete amputation of the upper skull and partial beheading. Homemade or modified commercial sawing instruments and the resultant injuries pose a number of forensic challenges starting from the death scene investigation, continuing with technical examinations, and concluding with determining the manner of death. As with all deaths due to sharp force injuries, fatalities involving power tools such as chainsaws, circular, and band saws warrant a high degree of suspicion of criminal activity and require diligence during all phases of the death investigation.

• Klíčová slova
• Amputation, Autopsy, Circular saw, Decapitation, Morphology, Suicide,
• MeSH
• lidé MeSH
• penetrující rány patologie   MeSH
• pitva MeSH
• poranění krku etiologie   patologie   MeSH
• poranění obličeje etiologie   patologie   MeSH
• sebevražda * MeSH
• senioři MeSH
• soudní patologie metody   MeSH
• traumatická amputace patologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH