Abstract
In cases of inflicted injury, the process of examining the patient for external injuries and documenting the findings is important for forensic assessment, including estimating or determining the type of weapon used and the circumstances of the violence. However, external examination is obviously limited in assessing internal injury. Here, we report the cases of two patients who survived stab wounds, where the findings of contrast-enhanced computed tomography (CT) performed for clinical diagnosis in the hospital were useful for forensic injury evaluation. In both cases, contrast-enhanced CT clearly displayed the injuries to the parenchymal organs and enabled the estimation of the direction and depth of the stab wounds by depicting the track and base of the wounds on acquired images. With the addition of the findings from examination of the external wound, the stab wounds in both victims were consistent with injury caused by the suspected weapon. Recently, imaging modalities including CT have become useful supplemental tools for precise forensic evaluation. Imaging findings obtained from these modalities could especially provide useful information for forensic assessment in clinical forensic medicine because examination of internal injury in the living body cannot generally be performed. Research on the precise diagnostic value of this method is required to utilize this method adequately in clinical forensic medicine.
Similar content being viewed by others
References
Grassberger M, Gehl A, Püschel K, Turk EE. 3D reconstruction of emergency cranial computed tomography scans as a tool in clinical forensic radiology after survived blunt head trauma--report of two cases. Forensic Sci Int. 2011;207:e19–23.
Wittschieber D, Beck L, Vieth V, Hahnemann ML. The role of 3DCT for the evaluation of chop injuries in clinical forensic medicine. Forensic Sci Int. 2016;266:e59–63.
Woźniak K, Rzepecka-Woźniak E, Moskała A, Pohl J, Latacz K, Dybała B. Weapon identification using antemortem computed tomography with virtual 3D and rapid prototype modeling--a report in a case of blunt force head injury. Forensic Sci Int. 2012;222:e29–32.
Borowska-Solonynko A, Solonynko B. The use of 3D computed tomography reconstruction in medico-legal testimony regarding injuries in living victims - risks and benefits. J Forensic Legal Med. 2015;30:9–13.
Pollak S. Clinical forensic medicine and its main fields of activity from the foundation of the German Society of Legal Medicine until today. Forensic Sci Int. 2004;1442-3:269–83.
Kodikara S. Practice of clinical forensic medicine in Sri Lanka: does it need a new era. Leg Med (Tokyo). 2012;144:167–71.
Odell M. Faculty of clinical forensic medicine: a major development in clinical forensic medicine. Emerg Med Aust. 2015;27:369–71.
Saukko K. Knight’s forensic pathology. 3rd ed. London: Arnold; 2004.
Flach PM, Thali MJ, Germerott T. Times have changed! Forensic radiology--a new challenge for radiology and forensic pathology. AJR Am J Roentgenol. 2014;202:W325–34.
Flach PM, Gascho D, Schweitzer W, Ruder TD, Berger N, Ross SG, et al. Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols. Forensic Sci Med Pathol. 2014;10:583–606.
Chidambaram S, Goh EL, Khan MA. A meta-analysis of the efficacy of whole-body computed tomography imaging in the management of trauma and injury. Injury. 2017;48:1784–93.
Ramirez RM, Cureton EL, Ereso AQ, Kwan RO, Dozier KC, Sadjadi J, et al. Single-contrast computed tomography for the triage of patients with penetrating torso trauma. J Trauma. 2009;67:583–8.
Scheurer E, Schoelzke S. Consent to forensic radiologic examinations by living crime victims. Int J Legal Med. 2014;128:323–8.
Malli N, Ehammer T, Yen K, Scheurer E. Detection and characterization of traumatic scalp injuries for forensic evaluation using computed tomography. Int J Legal Med. 2013;127:195–200.
Schuh P, Scheurer E, Fritz K, Pavlic M, Hassler E, Rienmüller R, et al. Can clinical CT data improve forensic reconstruction? Int J Legal Med. 2013;127:631–8.
Yen K, Vock P, Christe A, Scheurer E, Plattner T, Schön C, et al. Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings. Int J Legal Med. 2007;121:115–23.
Kirton OC, Wint D, Thrasher B, Windsor J, Echenique A, Hudson-Civetta J. Stab wounds to the back and flank in the hemodynamically stable patient: a decision algorithm based on contrast-enhanced computed tomography with colonic opacification. Am J Surg. 1997;173:189–93.
Inaba K, Okoye OT, Rosenheck R, Melo N, Branco BC, Talving P, et al. Prospective evaluation of the role of computed tomography in the assessment of abdominal stab wounds. JAMA Surg. 2013;148:810–6.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval
This article does not contain any studies involving human participants or animals performed by the authors.
Conflict of interest
The authors declare that they have no conflicts of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Inokuchi, G., Yoshida, M., Makino, Y. et al. Utility of contrast-enhanced computed tomography in forensic examination of a stab wound in living individuals. Forensic Sci Med Pathol 15, 463–469 (2019). https://doi.org/10.1007/s12024-019-00133-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12024-019-00133-2