Discipline of Pathology, The University of Adelaide, Adelaide, SA, Australia.
Int J Legal Med. 2010 Jan;124(1):71-3. doi: 10.1007/s00414-009-0319-x. Epub 2009 Feb 10.
A girl aged 21 months and a boy aged 3 years both died of hemorrhage from intestinal and mesenteric lacerations due to inflicted blunt abdominal trauma. Histologic examination of sections from the areas of duodenal and mesenteric lacerations confirmed changes of acute injury with hemorrhage, acute inflammatory infiltrates, and surface fibrin deposition. In addition, in both cases, there was also evidence of much longer-standing trauma with mesenteric fibrosis and hemosiderin-containing macrophages (the latter in keeping with previous hemorrhage). In the absence of a history of surgery and local inflammatory disease, these findings suggest that these children had suffered previous abdominal trauma, possibly from similar types of injuries. Scarring of the mesentery and intestine in cases of lethal childhood blunt abdominal trauma may provide evidence of previous similar, significant although sublethal tissue damage. Extensive histologic sampling of abdominal organs and tissues including the mesentery can, therefore, be extremely useful in such cases.
两名患儿，分别为 21 月龄女孩和 3 岁男童，均因腹部遭受钝性外伤导致肠和肠系膜撕裂而出血死亡。对十二指肠和肠系膜撕裂部位的切片进行组织学检查，证实了伴有出血、急性炎症浸润和表面纤维蛋白沉积的急性损伤改变。此外，在这两个病例中，还存在肠系膜纤维化和含铁血黄素巨噬细胞（与先前的出血一致）的证据，提示这两个孩子之前遭受过腹部创伤，可能是类似类型的损伤。在致命性儿童腹部钝性外伤的情况下，肠系膜和肠的瘢痕形成可能表明之前存在类似的、严重但未致命的组织损伤。因此，在这种情况下，对包括肠系膜在内的腹部器官和组织进行广泛的组织学取样非常有用。
