Wounds “jars”

1. Wounds“jars” By Dr / MarwaMagdy Demonstrator of forensic medicine & toxicology

2. Objectives: • How to comment on jars? • Description of different types of wounds. • Examples : spleen, heart, liver, kidney,…

3. How to comment? • Specimen: jar • Presenting part:spleen, liver, heart, …. • Diagnosis: lacerated wound, stab wound, cut wound,… 4. Description of injury: • Number • Site • Details of each type of wound( angles, edges, tissue bridging)

4. How to comment cont.? 5. Causative instrument: • Blunt instrument لا تذكر إسم الألة بالتحديد(سكينة أو • Sharp instrument شومة ) 6. Complications & possible cause of death, e.g: • Internal haemorrhage • Shock • Injury to vital organs • Loss of a functioning organ

5. Description of different types of wounds • Cut wound: الجرح القطعى • Two acute angles • Regular edges • No tissue bridging • Caused by a sharp instrument 2. Lacerated (contused) wound:الجرج التهتكى أو الرضى • Multiple angles • Irregular edges • Tissue bridging • Caused by a blunt instrument

6. 3.Stab wound:الجرح الطعنى • Has two angles • 1 acute & 1 rounded→single sharp bladed. • 2 acute angles→double sharp bladed • Regular edges. • It is deeper than longer. • No tissue bridging.

7. Examples

8. Lacerated spleen

9. Lacerated spleen • Specimen: jar • Presenting part:spleen • Diagnosis: lacerated spleen • Description of injury: • Multiple contused wounds on the visceral & diaphragmatic surfaces with multiple angles, irregular edges and tissue bridging. • There is capsular tear. • There is a subcapsularhaematoma. • Causative instrument: blunt trauma.

10. Complications & possible cause of death: • Massive internal haemorrhage. • Shock. • Surgical interference. • Loss of a functioning organ.

11. Stab wound in the spleen

12. Stab wound in the spleen • Specimen: jar • Presenting part: spleen • Diagnosis: stab wound • Description of injury: • Penetrating stab wounds in the spleen • Wounds are 2 in number • Wounds have regular edges, one acute angle & the other rounded, gapping and no tissue bridging.

13. Causative instrument: single sharp bladed instrument • Complications & possible cause of death: • Internal haemorrhage • Shock • Injury to vital organs • Loss of a functioning organ

14. Stab heart

15. Stab heart • Specimen: jar • Presenting part: heart • Diagnosis: stab wound in the heart • Description of injury: • Penetrating stab wound in the left ventricle with regular edges, 2 acute angles, gapping & no tissue bridging. • The stab wound is deeper than longer.

16. Causative instrument: double sharp bladed instrument. • Complications & possible cause of death: • Massive internal haemorrhage • Shock • Haemopericardium & cardiac tamponade • Injury to other vital organs

17. Perforated uterus

18. Perforated uterus • Specimen: jar • Presenting part: uterus & fallopian tubes • Diagnosis: perforated uterus • Description of injury: The uterus shows 3 perforations, 2 in the fundus and 1 in the anterior wall. • Causative instrument: pointed instrument • Complications & possible cause of death: • Massive internal & external haemorrhage • Haemorrhagic shock • Medicolegal importance MLI: this case is a suit of malpractice.

19. Lacerated wound in lung

20. Lacerated wound in lung • Specimen: jar • Presenting part: left lung • Diagnosis: lacerated wound in the left lung • Description of injury: The wound has irregular edges, multiple angles, tissue bridging & surrounded by contusions. • Causative instrument: blunt trauma • Complications & possible cause of death: Internal haemorrhage,shock,pneumothorax or haemothorax.

21. Lacerated liver

22. Lacerated liver • Specimen: jar • Presenting part: left lobe of the liver • Diagnosis: lacerated liver • Description of injury: Avulsed left lobe of the liver showing multiple lacerated wounds with irregular edges, multiple angles, tissue bridging & surrounded by contusions. • Causative instrument: blunt trauma • Complications & possible cause of death: Internal haemorrhage, shock

23. Lacerated kidney

24. Lacerated kidney • Specimen: jar • Presenting part: left kidney • Diagnosis: lacerated kidney • Description of injury: • The kidney shows a laceration dividing it into two parts united at the hilum by a pedicle. • It has multiple angles, irregular edges & tissue bridging. • Causative instrument: blunt trauma • Complications: internal haemorrhage, shock, loss of a functioning organ.

25. Ante mortem cut wound

26. Antemortem cut wound • Specimen: jar • Presenting part: part of lateral aspect of soft tissue of leg. • Diagnosis:antemortem cut wound • Description of injury: • The wound has regular edges, acute angles, no tissue bridging. • Swollen edges, gapping , blood infiltration. • Causative instrument: sharp instrument • Complications:haemorrhage, sepsis

27. Postmortem cut wound

28. Postmortem cut wound • Specimen: jar • Presenting part: part of lateral aspect of soft tissue of leg. • Diagnosis: postmortem cut wound • Description of injury: • The wound has regular edges, acute angles,no tissue bridging. • Less gapping, no swollen edges, no bleeding & no vital reaction. • Causative instrument: sharp instrument

29. Tentative marks

30. Tentative marks • Specimen: jar • Presenting part: skin of neck • Diagnosis: tentative marks(hesitation marks) in a case of cut throat. • Description: • Multiple parallel superficial cut wounds. • With regular edges, 2 acute angles, gapping & no tissue bridging. • Complications: massive haemorrhage, shock • MLI: tentative marks indicate suicidal manner of injury.

31. Thank you…..