Krispin Alon, Zaitsev Kounstantin, Hiss Jehuda
The National Center of Forensic Medicine, Assaf Harofeh Medical Center affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Harefuah. 2011 Mar;150(3):227-9, 305.
Hypothermia is a rare cause of death in Israel, and usually occurs among risk groups such as elderly people, homeless persons, psychiatric patients and persons who function in cold environments or are unintentionally exposed to such conditions. Death due to hypothermia generally occurs in extremely cold conditions, although ambient temperatures of 15-20 degrees C can also be lethal. The phenomenon of paradoxical undressing that characterizes death due to hypothermia rather occurs in moderate ambient temperatures, and takes place when the victim is in extremis. A case of death of an elderly man, whose body was found naked in a field, is reported. His head was covered with a shirt, and blunt injuries were found on his body, raising suspicion that he was smothered, or was a victim of sexual violence. On autopsy, spot hemorrhages of the gastric mucosa, which are characteristic of hypothermia, were found, along with mild cerebral atrophy, moderate atherosclerosis of the coronary and cerebral vessels and myocardial sclerosis. The combination of autopsy findings, elimination of traumatic injuries as contributors to death and the circumstances in which the body was found, led to the diagnosis of death due to hypothermia.
体温过低在以色列是一种罕见的死亡原因，通常发生在老年人、无家可归者、精神病患者以及在寒冷环境中工作或意外暴露于此类环境的人群等风险群体中。体温过低导致的死亡一般发生在极端寒冷的条件下，不过环境温度在15至20摄氏度时也可能致命。体温过低导致死亡所特有的反常脱衣现象反而多发生在中等环境温度下，且发生在受害者濒死之时。本文报告了一例老年男性死亡病例，其尸体被发现裸身于田野中。他的头部盖着一件衬衫，身上有钝器伤，这引发了他是被闷死或遭受性暴力侵害的怀疑。尸检时，发现了具有体温过低特征的胃黏膜点状出血，同时伴有轻度脑萎缩、冠状动脉和脑血管中度动脉粥样硬化以及心肌硬化。尸检结果、排除外伤作为死亡原因以及尸体被发现时的情况综合起来，得出了体温过低导致死亡的诊断结论。
