This case report describes a case of fatal intestinal obstruction in a 4-year-old girl caused by malrotation and internal hernia, which led to distortion and necrosis of the small intestine. Although resuscitation was immediately initiated, multiorgan failure and death occurred within hours of the onset of the first symptoms. Autopsy revealed extensive ischemic changes in the small intestine and a congenital mesocolon defect as the cause of the internal hernia. This case highlights the critical importance of considering internal hernias in the differential diagnosis of acute abdomen in pediatric patients and emphasizes the need for prompt surgical intervention. Early recognition and treatment are essential to prevent catastrophic consequences in these rare but life-threatening conditions.
Whole-body post mortem CT angiography (PMCTA) is an innovative and experimental imaging technique that relies heavily on interdisciplinary collaboration, access to skilled personnel, advanced technical equipment and the financial possibilities of the workplace. Native CT examinations (PMCT) prior to autopsy are already a standard procedure in certain forensic departments in the Czech Republic (e.g., murders, suicides, deaths of children, traffic accidents etc.). Nonetheless, the progression of forensic sciences all over the world shows the necessity to integrate other advanced imaging modalities in routine forensic practice. Incorporating PMCTA into standard forensic workflows enhances the precision of forensic diagnostics, supplements traditional autopsy findings, and elevates the objectivity of forensic outputs. This paper presents technical notes on the development of PMCTA in forensic practice in a department that since 2015 until now has routinely performed native CT examinations. Institutional support was crucial in enabling the adoption of the imaging technique, which has so far been applied to more than thirty cases. The department is currently conducting a comparative study focused on the application of three different types of perfusion media - polyethylene glycol (PEG), saline, paraffin oil - and assessing the diagnostic efficacy of PMCTA relative to conventional autopsy. Based on our experience, PMCTA is suitable for all corpses except those with advanced post-mortem decomposition or extensive open injuries. The highest diagnostic yield is achieved in cases involving suspected gastrointestinal bleeding or vascular pathologies and lesions especially of large vessels (e.g., dissection/rupture of the aorta). The protocol for whole-body PMCTA can be adapted to meet the specific needs and conditions of individual forensic departments, providing a flexible yet robust framework for enhancing forensic medical investigations.
Authors describe two cases of intoxications imitating of morphological changes in the brain in this work. Initially it was meant to stem a stroke. Later, it was found that it is an intoxication by Amanita dapple. To this must be meant in practice and at the first contact with the patient.
Previous studies have reported that respiratory infections can cause sudden death in infants. In one report, many infants had mild respiratory infection symptoms before their sudden death. However, we have also seen many cases of sudden death in asymptomatic infants who were diagnosed with respiratory infections based on detailed postmortem examinations. However, no study has investigated the differences between symptomatic death and asymptomatic death in infants with respiratory infections. In the present study, the risk factors for sudden death in infants with asymptomatic antemortem respiratory infections were investigated using forensic autopsy cases in our laboratory. The investigation showed that deaths associated with asymptomatic respiratory infections were relatively more common in infants younger than one year, of normal birth weight, and fed exclusively with formula milk, as well as infants who had fallen asleep within one hour of their last meal. The results reconfirmed that such small daily changes, such as expression and behavior changes, should be carefully observed when managing infants, including those with no apparent health problems.
Fire-related fatalities often result in extensive thermal destruction of human remains, posing significant challenges for forensic analysis. Although soft tissues are generally destroyed during exposure to high temperatures, rare cases may reveal selective internal organ preservation. This case report describes two individuals recovered from a recreational cabin fire in northern Slovakia, where most bodily structures were extensively carbonized and fragmented. Remarkably, the heart exhibited an intact internal morphology despite external carbonization. Macroscopic examination revealed preserved myocardium, distinguishable valve structures and voluminous cooked blood within the cardiac chambers. The pericardial sac and epicardial layer including coronary vasculature were thermally destroyed and thus non-evaluable. The preserved state of this organ, amid widespread anatomical destruction, suggests a thermal buffering mechanism mediated by retained blood and the histomorphological structure of the heart. This case underscores the importance of thoroughly examining severely burned remains, as preserved internal tissues may yield critical insights, contributing to the accurate reconstruction of death circumstances in fire-related fatalities.
