Citation

Taris M, Delbreil A, Lefrancq T, Gambier A, LeBeau M, Voyer M, Sapanet M. Rev. Med. Leg. 2014; 5(3): 128-131.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.medleg.2014.07.001

PMID

unavailable

Abstract

A body in an advanced state of putrefaction was recovered at the bottom of a ledge. It could have been that of a man missing for one month, who had left a suicide note in his home. He had contacted emergency services by phone, claiming to be seriously hurt but failing to specify either his whereabouts or the nature of his injuries. The face and the neck were skeletal, whereas the hyoid bone was detached from the other laryngeal cartilages and showed no signs of abnormality. On autopsy, different types of traumatic injuries were detected, including fractures, bruises and hematomas. In addition, the thyroid cartilage presented a thin notch at the base of the right upper horn of which the exact nature could not be determined by macroscopic examination alone. The appearance of this abnormality was evocative of a stab wound and led to the following differential diagnoses: anatomical variation and postmortem or per-autopsy injury. The histological appearance of bone or cartilage damage caused by stabbing has been described in the literature in a few cases. Risk of thyroid cartilage fracture increases with age, and the base of the upper horns is the preferential location. In our case, microscopic analysis showed incompletely ossified fibrous tissue, bordered by a line of enchondral ossification. It is a characteristic element of the age of the lesion. Pathological examination confirmed the conclusion of the autopsy, according to which death had ensued following a fall from a great height and the resultant chest trauma (probably massive hemopneumothorax). The thyroid cartilage lesion was not contemporary with the death, and there could consequently be no suspicion of a recent violent stab. © 2014 Elsevier Masson SAS.

Language: fr

Keywords

human; age; male; injury; Pathology; autopsy; case report; risk factor; stab wound; differential diagnosis; fracture; larynx disorder; human tissue; Fracture; emergency health service; larynx cartilage; pathological anatomy; hematoma; Thyroid cartilage; histopathology; disease duration; Article; bone injury; microscopy; Anatomical variation; atypical lesion of thyroid cartilage; enchondral ossification; fibrous tissue ossification; Knives; ossification