Citation

Shinkawa N, Kakizaki E, Sonoda A, Yukawa N. J. Forensic Leg. Med. 2022; 92: e102452.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.jflm.2022.102452

PMID

36379110

Abstract

[A type of patterned injury can be observed occasionally in the form of the so-called “tramline” bruise. This type of bruise occurs when the skin surface is struck by a cylindrical or rectangular object, producing an area of central pallor outlined by two narrow parallel lines of bruising]

An autopsy case involving a child showing various shapes of tramline bruises caused by a single weapon is described. On autopsy, multiple tramline bruises in different orientations were found, mainly on the back. Shapes of the tramline bruises were variable, including linear, arcuate, nodular, hook-like, and hook-like with a knot at the end. Due to the presence of severe subcutaneous hemorrhages and the absence of other potentially fatal injuries or diseases, we determined the cause of death to be traumatic shock. Microscopically, of the many tramline bruises, characteristic hemorrhages were observed on the right abdominal and left lumbar regions. Those hemorrhages were observed in the dermis, corresponding to macroscopic tramline bruises. Hemorrhage was also observed in the subcutis, corresponding to the pallor of the outer surface. The mechanisms by which tramline bruises occurred in the dermis and subcutis in this case are discussed with reference to the literature. We also propose subcutaneous and intradermal hemorrhagic types of tramline bruising.

Language: en

Keywords

Double linear marks; Forensic pathology; Tramline bruise