The American journal of forensic medicine and pathology
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Am J Forensic Med Pathol · Dec 2001
Case ReportsFatal carbon monoxide poisoning after the detonation of explosives in an underground mine: a case report.
An unusual death caused by carbon monoxide poisoning after the detonation of explosives in an underground mine was investigated by the Office of the Medical Investigator of the State of New Mexico. The 50-year-old miner had 18 years of mining experience but no documented safety training. He collapsed approximately 20 minutes after entering the mine and working at the bottom of the single vertical shaft. ⋯ The autopsy showed severe coronary artery atherosclerosis with remote and resolving myocardial microinfarcts, as well as the characteristic pink lividity of carbon monoxide poisoning, which was confirmed by laboratory analysis. Detailed investigation of the scene revealed no sources of carbon monoxide other than the explosives. The case represents an uncommon cause of death in mining that may have been avoided through the use of proper safety procedures, and illustrates the importance of recognizing the many sources of carbon monoxide.
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Am J Forensic Med Pathol · Sep 2001
Review Case ReportsSmall bowel perforation as a complication of microsurgical lumbar diskectomy. A case report and brief review of the literature.
Ventral perforation is a rare complication of lumbar diskectomy. Injury to retroperitoneal vessels is the most common serious complication to such perforation. Ventral perforation with damage to the bowel is rarely reported. ⋯ The case illustrates the importance of awareness of bowel injury as a possible complication of diskectomy. Possible pre- and postoperative considerations are also discussed. A brief review of the literature on bowel injuries after this common surgical procedure is also given.
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Am J Forensic Med Pathol · Sep 2001
Case ReportsUnique case of fatal carbon monoxide poisoning in the absence of a combustible fossil fuel.
A 37-year-old man died as a result of exposure to carbon monoxide within an apartment. An investigation of the apartment showed no gas appliances or gas supply to the apartment and no evidence of any combustion event to any part of the apartment or roof space. ⋯ Heating to the apartment was found to be via an electrical storage heater, the examination of which revealed that the cast-iron core and insulating material showed evidence of heat damage with significant areas devoid of carbon. This electric storage heater is hypothesized to be the source of carbon for the fatal production of carbon monoxide within the apartment.
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Am J Forensic Med Pathol · Jun 2001
Practice Guideline GuidelinePosition paper on fatal abusive head injuries in infants and young children.
This article represents the work of the National Association of Medical Examiners Ad Hoc Committee on shaken baby syndrome. Abusive head injuries include injuries caused by shaking as well as impact to the head, either by directly striking the head or by causing the head to strike another object or surface. Because of anatomic and developmental differences in the brain and skull of the young child, the mechanisms and types of injuries that affect the head differ from those that affect the older child or adult. ⋯ Rotational movement of the brain damages the nervous system by creating shearing forces, which cause diffuse axonal injury with disruption of axons and tearing of bridging veins, which causes subdural and subarachnoid hemorrhages, and is very commonly associated with retinal schisis and hemorrhages. Recognition of this mechanism of injury may be helpful in severe acute rotational brain injuries because it facilitates understanding of such clinical features as the decrease in the level of consciousness and respiratory distress seen in these injured children. The pathologic findings of subdural hemorrhage, subarachnoid hemorrhage, and retinal hemorrhages are offered as "markers" to assist in the recognition of the presence of shearing brain injury in young children.
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Am J Forensic Med Pathol · Dec 2000
Case ReportsMechanical airway obstruction caused by accidental aspiration of part of a ballpoint pen.
The authors present three cases of death in children aged 4, 9, and 10 years, respectively, that were first thought to be caused by herbal or other poisonings but at autopsy were found to be caused by airway obstruction from aspiration of ballpoint pen parts. Aspiration of a foreign body is a leading cause of accidental death in children, but the circumstances in these cases were unique. In the first case, a 4-year-old child died shortly after a visit to a traditional healer. ⋯ Features of "asphyxial" death were present, and included subconjunctival hemorrhages, subendocardial hemorrhages, and congestion of the face and internal organs. These deaths are preventable by education of children, parents, and teachers. Ballpoint pen manufacturers should also modify the design of these pens to improve their safety.