Dmitrieva O A, Smirnova E V
Sud Med Ekspert. 2011 Jan-Feb;54(1):28-31.
The results of analysis of 46 commission forensic medical expertises are presented based on the materials concerning injuries and changes in the anorectal region and rectum unrelated to attempts at sexual abuse. The materials were collected and stored by the Primorskoye territorial Bureau of forensic medical expertise during 5 years, from 2005 to 2009. All injuries and changes were categorized into several groups in terms of their origin, viz. car accidents, inadequate medical care, insertion of foreign bodies, falls on sharp and protruding objects, gunshot wounds, chemical and thermal burns, sports training, etc. The occurrence of the injuries is illustrated by the examples from forensic medical practice. It is concluded that experts describing injuries and changes in the anorectal region and rectum must act in conformity with the order of the Russian Ministry of Health No 346 dated October 21, 2010) and use instrumental methods and terminology accepted in modern proctology. The severity of harm to health in subjects presenting with injuries and changes in the anorectal region and rectum should be evaluated in terms of both the degree of the threat to life and the outcome of the treatment with special reference to the duration of health impairment, severity of the trauma, and its consequences (anorectal dysfunction).
本文基于与性虐待企图无关的肛门直肠区域和直肠损伤及变化的材料,呈现了46例委托法医鉴定的结果。这些材料由滨海边疆区法医鉴定局在2005年至2009年的5年时间里收集和保存。所有损伤和变化根据其成因分为几组,即交通事故、医疗护理不当、异物插入、摔倒在尖锐突出物体上、枪伤、化学和热烧伤、体育训练等。通过法医实践中的实例说明了损伤的发生情况。结论是,描述肛门直肠区域和直肠损伤及变化的专家必须符合俄罗斯卫生部2010年10月21日第346号命令的要求,并使用现代直肠病学中认可的仪器方法和术语。对于肛门直肠区域和直肠有损伤及变化的患者,健康损害的严重程度应根据对生命的威胁程度以及治疗结果进行评估,特别要参考健康损害的持续时间、创伤的严重程度及其后果(肛门直肠功能障碍)。