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Power hammers are mechanised forging devices that constitute a pivotal part of steel manufacturing. Power hammer‐associated injuries are a rare occurrence. We report a noteworthy case of a 52‐year‐old man who sustained a high‐energy penetrating injury while working with a power (counterblow) hammer. The man used a sizable disc‐shaped metallic object to dislodge the forging wedged in the machine by applying the force of the striking ram on it. On impact, the object ejected and struck the man in the right lateral portion of the chest. The autopsy disclosed extensive damage to the thoracic and abdominal organs. The cause of death was opined to be exsanguination due to penetrating trauma of the heart and transection of the descending aorta. The investigation confirmed a breach of safety regulations. To the best of our knowledge, this is the first power (counterblow) hammer‐related fatality in medico‐legal literature. [ABSTRACT FROM AUTHOR]

This letter discusses a case of complex suicide involving a power drill and self-immolation. The authors describe the injuries sustained by a 61-year-old male, including burns, a drilled hole in the forehead, and drilled wounds on the chest and abdomen. The autopsy revealed that the man likely died from burns and smoke asphyxiation, with the penetrating intracranial wound from the power drill serving as a contributory factor. The authors note that suicides involving power-driven tools are uncommon, and the appearance of drill injuries can vary depending on various factors. The case also highlights the use of multiple methods in complex suicides and the potential for misinterpretation of injuries. [Extracted from the article]

Geocaching is a high-tech treasure-hunt game that uses GPS-enabled devices or smartphone apps to find cleverly hidden treasures marked by GPS coordinates that are shared online. Like any other outdoor activity, geocaching is associated with risks of falls, environmental injuries, asphyxia and natural events. Despite the apparent risk of serious injury and potential death, no relevant reports aiming to identify the characteristics of geocaching-related deaths have appeared in the medical literature to date. We report a case of an experienced geocacher who was found suspended from a bridge pillar with his climbing ropes and helmet straps twisted across his face and neck; he had apparently attempted to rappel from a 30-m-high railway bridge to find a geocache. A recording of the rappelling sequence from the camera found on the chest strap assisted in reconstructing what had actually happened. An autopsy confirmed that the cause of death was asphyxiation due to hanging, with the occlusion of the external airways and positional asphyxia serving as contributory factors. The salient features of this unusual case are discussed, and several forensic issues of geocaching are highlighted. [ABSTRACT FROM AUTHOR]

Laryngohyoid fractures in hanging victims are one of the most studied and paradoxically contradictory topics in forensic pathology. According to literary sources, the incidence of laryngohyoid fractures in hanging varies significantly, from 0% to 100%. To verify the diagnostic significance of these injuries in hanging, we prospectively and consecutively analyzed the occurrence of laryngohyoid fractures in a group of 178 suicidal hanging victims (M/F=150/28, aged 14-94years, mean age=50, complete suspension=111 cases, partial suspension=67 cases) in relation to selected variables (age, sex, weight, the completeness of body suspension, and ligature knot location). Altogether, we identified the following types of laryngohyoid fractures in 129 of 178 cases (72.5%): isolated fracture(s) to the thyroid cartilage in 60 cases (33.7%), combined thyrohyoid fractures in 41 cases (23.0%), isolated fracture(s) to the hyoid bone in 28 cases (15.7%), and no fractures to the cricoid cartilage or the cervical vertebrae. The highest frequency of laryngohyoid fractures was found in lateral hangings (right lateral: 26/34, 76.5%; left lateral: 31/37, 83.8%), whereas the lowest rate was found in anterior hangings (4/11, 36.4%). In lateral hangings, fractures more often occurred contralaterally to the suspension point. Statistical analysis revealed significant associations of the occurrence of laryngohyoid fractures with the age of the victim (p=0.028), with the position of the ligature knot on the neck (p=0.019) and with the age-corrected weight of the victim (p=0.026). In addition, we performed a systematic updated review and critical appraisal of relevant literary sources to report the incidence, fracture patterns, and contributing variables of laryngohyoid injuries in hanging. Both the results of our study and the provided literary synthesis show that if evaluated properly, laryngohyoid fractures in hanging may diagnostically offer far more than just evidence that injury to the neck occurred and may also present research opportunities regarding several issues that should be further analyzed and explained. [ABSTRACT FROM AUTHOR]

Strangulation of the heart appears to be an exceedingly rare mechanical phenomenon that can develop with epicardial pacing wires in individuals undergoing somatic growth. Over the passage of time, owing to size mismatch between a fixed wire length and dynamically growing heart, the epicardial wire may embed around the heart resulting in the progressive over-pressurizing of involved cardiac structures. Depending on the location of the peak constriction pressures, cardiac strangulation may damagingly affect coronary circulation, heart valves function, or physiologic filling of the heart chambers, with risk of myocardial ischemia, decreased cardiac output, acute cardiac failure, ventricular arrhythmias and death. We report a case of a 29-year-old male with sudden cardiac death owing to cardiac strangulation with epicardial pacing wire that had been retained in place almost 30 years. At autopsy, an enlarged and abnormally contoured heart was found to be strangulated by an epicardial pacing wire; histopathologic examination confirmed hypertrophy of the myocardial fibers, myofiber disarrangement, and replacement-type fibrolipomatosis. In addition, this article consolidates the available literature on cardiac strangulation by an epicardial wire and highlight relevant clinical and medico-legal features for the forensic professionals. [ABSTRACT FROM AUTHOR]

Multiple giant aneurysms involving the coronary arteries are uncommon and rarely reported. In the presented case, a 63-year-old man with poorly controlled hypertension died suddenly. Gross autopsy examination showed multiple giant thrombus-filled coronary artery aneurysms, atherosclerotic coronary artery disease, and cardiomegaly. Histological sections of the coronary aneurysms showed atherosclerotic changes with both organized and fresh thrombus. Giant coronary aneurysm is defined as a segmental enlargement of a coronary artery with a diameter exceeding 20 mm or more. The main etiology of this nebulous entity is attributed to atherosclerosis and inflammatory or inherited connective tissue disorders with the remainder being congenital, infectious, or idiopathic. Before its cataclysmic presentation, when ruptured or thrombosed, giant coronary aneurysm usually has a silent clinical course. Sudden death owing to giant multiple coronary aneurysms is rare and mandates careful classification of the aneurysms and prudent search for autoimmune-mediated or genetically based factors for subsequent ancillary autopsy studies. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The article discusses the sudden death of a male patient due to renal cell carcinoma (RCC) pulmonary embolism. Topics discussed include the patient's development of sudden-onset dyspnea, autopsy which revealed a tumor in the right kidney and immunohistochemistry which confirmed renal cell carcinoma. Also mentioned are the classification of pulmonary embolism and sarcomatoid transformation in RCC.

In forensic assessment, denial and concealment of pregnancy has wide-ranging implications including criminal abortions, extramural deliveries, concealment of birth, newborn infant abandonment or even neonaticide. Clarification of whether a newborn was born alive is the most important factor when evaluating an abandoned neonate or concealment of birth. Other points that need to be addressed are determination of viability and maturity of the newborn infant, and the identity of the mother. A prolonged postmortem interval following illegal disposal of a dead body often leads to advanced decomposition, making postmortem elucidation difficult. We report an exceptionally uncommon autopsy case of a well-preserved female newborn, which was accidentally found after eight years in a home freezer. Despite the prolonged postmortem interval, tissue preservation was sufficient for a meaningful autopsy including a comprehensive histopathological study. The purpose of the present investigations was to expand our understanding of thanatological processes, as well as detectability of particular histological findings on the remains of a newborn after extremely prolonged storage in an artificially frozen environment. In addition, this article discusses forensically important issues regarding concealment of newborn infant under specific conditions. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 32-year-old woman who collapsed after visiting the toilet. It mentions that she was a long term intravenous drug (IVD) user with history of IVD abuse. It also informs about histological examination of the lesions on the tricuspid valve and the mass from the pulmonary artery which revealed an organizing thrombus with numerous colonies of bacteria.

The article presents a case study of a 46 year old man who was taken for autopsy evaluation after he was found dead in his house compound area. External blood loss by transection of the right femoral artery and vein after an impaling injury led to the death. The death was declared accidental. The article discuses laceration, retroperitoneal space and hemorrhage.

The article presents the case study of a 50-year-old man, who had chronic alcoholism and four-week history of abdominal pain and referred to a hospital for autopsy evaluation after his sudden death. External examination revealed a distended abdomen and further abdominal examination showed necrosis and well-demarcated process in liver tissue. The case informs about the development of substantial complications followed by abdominal trauma.

The article presents case study of a 89-year-old woman who was found dead in the corridor of her apartment. It states that woman had a past medical history including chronic venous insufficiency of the lower limbs and ischemic heart disease. It further talks about lipomatous hypertrophy of the interatrial septum (LHIS), also termed as "massive fatty deposits in the interatrial septum," a rare benign tumor-like condition of human body.

The article presents a case study of 88 year old man who died due to bronchopulmonary infection with his autopsy revealing that he had chronic pulmonary disease and ischemic heart disease. It informs that cause of the death was found to be transmural intestinal necrosis caused by arterial thrombotic occlusion. It states that giant Lambl's excrescences, lesions that form thromboemboli, caused obstruction of coronary ostium and resulted in death.

In recent years, Slovakia's brown bear (Ursus arctos arctos) population has expanded, accompanied by increased injuries, public fear of bear attacks, and the first bear-related fatality in recent decades. From 2000 to 2015, 54 brown bear attacks on humans were recorded in Slovakia with no fatalities. The authors report on a fatal bear attack from 2021, the first known bear-caused fatality in Slovakia since 1927. The victim was a 58-year-old male found dead with numerous injuries consistent with brown bear attack. The autopsy revealed a diffuse subarachnoid hemorrhage and fracture of the cervical spine with contusion and partial spinal cord tear, which ultimately led to death due to central nervous system failure. To avoid potential conflicts between humans and wild animals, wildlife management authorities must develop educational safety programs, and encourage behavioral changes among outdoor recreationists as well as responsible wildlife viewing practices. [ABSTRACT FROM AUTHOR]

Autoerotic deaths refer to fatalities occurring during individual, solitary sexual activity, in which some device, situation, or act is used to gain or boost the sexual arousal of the subject. Anorectal autoeroticism is an autoerotic paraphilic activity that pertains to the self-insertion of various objects into the anal canal and rectal cavity to gain or heighten the subject's sexual drive. Although most foreign bodies inserted into the rectum do not cause significant injury, the introduction of some objects into the rectum might have unpredictable and even fatal effects. In this paper, we describe an intriguing autoerotic case of a 35-year-old male who sustained an explosive rectal trauma as a result of the unanticipated bursting of an expandable rubber pipe stopper that he inserted into his rectum and hyperinflated via an air blow gun connected through a pressure pipe to a centralized air-distribution system. The man sustained a circular abruption of the rectum with partial avulsion of the abdominal wall, associated with bleeding into the abdominal cavity and chest wall, and died before admission to the hospital. A police investigation revealed that the victim was a regular contributor to several web forums dedicated to unusual sexual activities. This case raises awareness of the broadening spectrum of methods and experiments associated with autoerotic behavior. We also reviewed the literature pertaining to this topic and outlined some of the characteristics of atypical autoerotic deaths. Although certain autoerotic methods are relatively common, other unusual autoerotic techniques may present novel challenges within the medicolegal field. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Tongue protrusion as an indicator of vital burning" by H Bernitz and colleagues published in a 2013 issue.

The concept of spontaneous combustion has huge appeal as an historical fiction but it has no scientific background. However, in some deaths involving fire, a body can burn away virtually completely with minimal thermal destruction to the neighboring environment. We report an extraordinary case of the self-immolation of an elderly woman who set herself on fire with suicidal intentions. The unusual appearance and location of the body closely resembled the phenomenon of so-called spontaneous human combustion because the upper parts of the body were almost totally destroyed by fire, while the legs and surrounding structures remained almost untouched by flames. The results of all investigations proved that the woman set fire to her body using a box of matches and accelerants (concentrated ethanol and a solid firelighter). Near-total combustion of her body subsequently occurred during the postmortem period. The development of alleged spontaneous human combustion requires the following: ignition (external heat source), fuel (molten human fat), a wick (e.g. charred and porous clothing, bedding, or ground), time, and an optimal microclimate for gradual burning. [ABSTRACT FROM AUTHOR]

Despite the availability of modern imaging and molecular tools, traditional autopsy, and laboratory findings remain the gold standard for the diagnosis of drowning. This article presents two cases of freshwater drowning in which hemolytic staining of the endocardium of the left heart chambers was observed at autopsy. One case was a suicidal drowning of an 84-year-old man, and the other case was an accidental drowning of an 86-year-old woman. In both cases, there was marked hemolytic staining of the endocardium of the left atrium and ventricle. The endocardium of the right heart chambers was clear and transparent in appearance. Hemolytic intimal staining of the aortic root was observed in one case. Gettler's test was positive in both cases. Hemolytic discoloration of the endocardium of the left heart chambers after freshwater drowning is analogous to hemolytic staining of the aortic root. Both staining patterns result from the hypo-osmolar hemolysis that occurs in the left heart chambers and systemic circulation after hypotonic fluid passes across the alveolocapillary membrane. Hemolytic discoloration of the endocardium of the left heart chambers at autopsy may support a diagnosis of freshwater drowning. [ABSTRACT FROM AUTHOR]

Dear Editors, We would like to share our recent observation encountered in two consecutive homicidal cases of traumatic neck compression, in both of which we have identified the presence of grossly visible hemorrhage in the ethmoidal sinus - a previously unreported autopsy finding in such a context. A layered anterior neck dissection in the bloodless field disclosed hemorrhages of both sternocleidomastoid muscles with extensive hemorrhages of the subcutaneous soft tissues and both carotid sheaths. Despite all, ethmoidal hemorrhage in fatal neck compression is an interesting and unexpected finding that needs rigorous systematic studies on larger cohorts to determine further validity, incidence, and diagnostic importance in forensic autopsy practice. [Extracted from the article]

Cardiovascular diseases are the most common cause of the mortality in developed countries. The coronary artery disease is on the first place as a cause of a death what represent seven million people every year and 12.8 % from all deaths in the world. Every sixth man and every seventh woman die of myocardial infarction (MI). Diabetes mellitus (DM) belongs to the most common chronic diseases and cardiovascular diseases occur with this diagnose 4-8 times more often. The acute complications of DM are caused by sudden metabolic decompensation, which can directly threaten the life of the patient. We present a case report of 20 years old woman with juvenile DM and a progression to severe ketoacidosis during the application of insulin with insulin pump. This acute metabolic complication led to an acute myocardial infarction (AMI) with the elevation of ST segment (STEMI). Urgent coronary angiografy was performed and single vessel involvement wth LAD TIMI flow 0 was found. LAD was filled by thrombotic material. Primary coronary intervention was performed with thrombi removal by thrombectomy catheter, nevertheless the flow in LAD was not restored in midportion and distal vessel with TIMI flow 1 only. [ABSTRACT FROM AUTHOR]

The postmortem diagnosis of hypothermia remains problematic even in the era of molecular and digital diagnostic advances. Gross hemorrhages in iliopsoas muscles have been regarded as a helpful diagnostic sign in hypothermia fatalities; nevertheless, they have received marginal attention since their original description. The present study attempts to fill that void by examining occurrence, localization, and diagnostic significance of the bleeding into the core muscles as evidence of death due to hypothermia in a series comprising 51 consecutive hypothermia autopsy cases. Hemorrhages into the core muscles were identified in 33 cases of fatal hypothermia (65%). Hemorrhages were present in iliopsoas muscles (19 cases; 37%), deep back muscles (18 cases; 35%), and in other core muscular groups such as the diaphragm, cervical, pectoral, and intercostal muscles (11 cases; 22%). The results of the study offer an attractive diagnostic opportunity and reaffirm the potential of the careful core muscle dissection for the clarification of hypothermic deaths. Centers lacking high-end imaging technologies and molecular postmortem programs may especially benefit, which may have implications in broader autopsy practice. [ABSTRACT FROM AUTHOR]

The muzzle imprint mark characteristically associated with contact or near contact entrance gunshot wounds exemplifies one of the most informative external findings in forensic medical practice. The presence of the muzzle imprint mark on the body's surface proves ballistic trauma, point of entry, and range of fire. Moreover, its appearance and configuration may indicate the type of the involved weapon and the way the firearm had been positioned and held at the time of discharge. In this paper, we present the contact shot wound pattern of an 83-year-old man who committed suicide with a Frommer Stop 12 M autoloading pistol of caliber 7.65 mm Browning. Initially, the muzzle imprint mark configuration in relation to the entrance gunshot defect in the victim's right temple indicated an unusual application or orientation of the pistol's barrel during discharge, thus, strongly suggesting a non-suicidal act. However, a critical confrontation of postmortem findings along with the results of ballistic expertise provided a clear explanation, which comprised the remarkable construction and unique muzzle design of the used handgun. [ABSTRACT FROM AUTHOR]