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溺水时的胃黏膜病变:其在法医病理学中的应用价值

Gastric mucosa lesions in drowning: its usefulness in forensic pathology.

作者信息

Blanco Pampín J, García Rivero S A, Tamayo Noemí M, Hinojal Fonseca R

机构信息

Department of Forensic Medicine and Pathology, Ministry of Justice, C/Viena s/n, 15701 Santiago de Compostela, Spain.

出版信息

Leg Med (Tokyo). 2005 Mar;7(2):89-95. doi: 10.1016/j.legalmed.2004.09.001.

Abstract

In a retrospective study of 52 autopsy cases of drowning fatalities, death circumstances, macroscopical and histological findings of the stomach mucosa were carefully studied. Results were compared with a control group, composed by 80 cases of different kinds of asphyxia (hanging, chocking and suffocation), skull injuries, sudden cardiac death and poisonings. The spectrum of gastric lesions observed during autopsy in drowning group, are presented. Stomach mucosa tears were found in 21.1% of the cases of drowning, preferably on fundus (54.5%). The control group does not show similar lesions. The physiopathological mechanism of its production, are also discussed. On sight of these results, it is concluded that the macro and microscopical examination of the stomach could be useful as an adjunct procedure for drowning diagnosis. The presence of gastric mucosa lesions has an intravital significance and could be correlated with other anatomical or histological signs of drowning for the diagnosis. In every case, necropsic examination must be carried out as soon as possible in order to avoid putrefactive artifacts.

摘要

在一项对52例溺水死亡尸检病例的回顾性研究中,对死亡情况、胃黏膜的宏观和组织学发现进行了仔细研究。将结果与一个由80例不同类型窒息(上吊、哽噎和窒息)、颅脑损伤、心源性猝死和中毒病例组成的对照组进行了比较。文中呈现了溺水组尸检期间观察到的胃部病变情况。在21.1%的溺水病例中发现了胃黏膜撕裂,最常见于胃底(54.5%)。对照组未显示出类似病变。文中还讨论了其产生的生理病理机制。基于这些结果,得出结论:对胃进行宏观和微观检查可作为溺水诊断的辅助程序。胃黏膜病变的存在具有生前意义,并且可与溺水的其他解剖学或组织学征象相关联以用于诊断。在每种情况下,都必须尽快进行尸检以避免腐败假象。

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