Browsing by Author "Pedrosa, F"
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- "Death by a thread" - Peritonitis due to visceral perforation by a guide wire, during proximal femur osteosynthesis with DHS: A fatal case and legal implications.Publication . Durão, C; Barros, A; Guerreiro, R; Pedrosa, FIatrogenic intestinal perforations in orthopaedic surgery are very rare. Reports of iatrogenic lesions caused by a guide wire during femur fracture osteosynthesis are even scarcer. There are no similar reports in recent literature. As opposed to what is normally described the lesion documented in this case report was not identified on time resulting in death by peritonitis. The forensic autopsy allowed the identification of an intestinal perforation with faecal leakage to peritoneal space in association with a vesical perforation enabling the reproduction of the guide wire path. In view of the increasing number of osteosynthesis it is essential for the surgeon to be aware of possible complications due to guide wire perforations. Cases like this go unnoticed if the forensic pathologist is not familiarized with the surgical technique which may explain the rarity of such descriptions in literature.
- Enlarged parietal foramina: a rare forensic autopsy findingPublication . Durão, C; Carpinteiro, D; Pedrosa, F; Machado, MP; Cunha, EEnlarged parietal foramina (EPF) are a quite rare developmental defect of the parietal bone which has to be distinguished from the normal small parietal foramina. We report a forensic case of an individual found in an advanced state of putrefaction in his own house with an undetermined cause of death. No evidence of trauma was observed, and the toxicological exam was negative. The victim was a 40-year-old man with a history of epilepsy. The large biparietal foramina, a rare anatomical variation and unusual autopsy finding, were observed at autopsy. The recognition of anatomical variations is important to avoid false interpretations and conclusions and has a significant potential as an identity factor, thus contributing to positive identification.
- A fatal case by a suicide kit containing sodium nitrite ordered on the internetPublication . Durão, C; Pedrosa, F; Dinis-Oliveira, RJFatal sodium nitrite poisonings are rare in the forensic context. The present work describes a first fatal case of sodium nitrite contained in a suicide kit that the victim acquired over the internet. The results of the autopsy showed general signs of asphyxia, such as intense cyanosis of the extremities, brown-gray-blue-red livor mortis, and some Tardieu petechiae in addition to intense visceral congestion. It is clear that forensic experts must be aware of the proliferation of this market and the risks of improper selling of these substances through suicide support networks available on the internet. The lack of knowledge of this reality may become unidentifiable, when toxicological analysis contemplates only the most classical and frequent substances involved in poisoning and reinforce the importance of a careful analysis of the death scene.
- Mortes por Asfixias com Alimentos em Crianças: Aspectos Médico Legais da Sufocação Direta por EngasgamentoPublication . Durão, C; Durão, D; Pedrosa, FThe asphyxia by suffocation (choking) with foreign bodies are dramatic. Among these, the choking with food are responsible for most of these deaths. Children under four years old are particularly vulnerable due to not having a well-developed posterior dentition. The paper presents the report of two cases of suffocation with food and discusses some legal medical concepts, warning of the further prevention of such cases.
- Sudden death associated with melanoma brain metastasesPublication . Durão, C; Marcos, VG; Nina, P; Gonçalves, MM; Pedrosa, FA 48-year-old male Caucasian, with no relevant medical history except for a mild depression, was found by the partner, passed out on the bedroom floor. Since he was found in cardiac arrest, cardiopulmonary resuscitation was attempted, without success. Initially, it was suspected to be a suicide attempt and autopsy findings revealed coronary atherosclerosis of about 40%, with no other recoverable cardiac findings. The brain showed multiple probable neoplastic lesions, associated with cerebral and cerebellar hemorrhage. The primary tumor was not identified, but the victim had multiple cutaneous nevi. Histological examination revealed melanoma metastases, confirmed by immunohistochemistry. In this case, the forensic autopsy allowed an accurate determination of the cause of death. Besides having fulfilled its role to the judiciary system, the autopsy also had relevance from an epidemiological point of view, which is essential for Public Health prevention programs.
- The importance of pelvic ring stabilization as a life-saving measure in pre-hospital - A case report commented by autopsyPublication . Durão, C; Alves, M; Barros, A; Pedrosa, FHip fractures with unstable pelvic ring have great morbidity and mortality rates. These fractures result from high energy trauma such as falls from heights, road accidents and collapsing structures or other similar mechanisms of action. We report the case of a 63 years old man, construction worker, who stood inside a ditch during a wall construction when he was surprised by this collapse, which resulted in direct trauma to the right thigh and pelvis. The autopsy revealed diaphysis fracture of the right femur with an open book pelvic fracture with severe hemorrhagic infiltration and hematoma of the pelvic muscles without arterial injury. Bone bleeding and the vascular damage associated with disruption of the sacroiliac ligaments promote a very significant bleeding. Simple maneuvers such as sheet circumferential compression to promote pelvic ring closure are effective on stabilizing and closure of the sacroiliac joint. Hip manipulation of the fracture was performed during the necropsy to demonstrate and prove how a simple sheet contention can promote stabilization of the pelvic ring by closing the sacroiliac joints in open book fractures.
- Undiagnosed intracranial lipoma associated with sudden deathPublication . Durão, C; Pedrosa, FIntracranial lipomas represent less than 0.1% of all intracranial tumors. They are usually located in the callus area and often asymptomatic. This paper presents a sudden death case after an episode of convulsions on a 39 years old woman with a history of migraines and seizures since adolescence. The autopsy revealed the presence of an undiagnosed massive brain lipoma (60 × 35 mm) associated with atrophy of the corpus callosum. Although very rare and seldom malignant these may be associated with seizures and sudden death.