Byard Roger W
Discipline of Anatomy and Pathology, The University of Adelaide, Level 3 Medical School North Building, Frome Road, Adelaide, SA 5005, Australia.
J Forensic Leg Med. 2012 Oct;19(7):419-21. doi: 10.1016/j.jflm.2012.02.002. Epub 2012 Apr 20.
It has been proposed that the absence of injuries to the outside of a body that has been subject to blunt trauma indicates that the forces involved were relatively minor. It has also been suggested that an autopsy will be unlikely to uncover any significant injuries. A series of cases involving lethal blunt trauma from vehicle crashes and falls are described where minimal external injuries were associated with major disruption of internal organs. Skin is both resilient and elastic enabling it to resist injury, while allowing considerable forces to be transmitted to the musculoskeletal system and internal organs beneath. The absence of external injury is not, therefore, synonymous with lesser degrees of force, and should not discourage full medicolegal investigation of cases where occult trauma may be a possibility. As Casper was one of the earliest to describe this phenomenon, perhaps the term 'Casper's sign' should be used when massive internal injuries from blunt trauma are found in the absence of significant injuries to the skin.
有人提出，遭受钝器创伤的身体外部没有损伤表明所涉及的力量相对较小。也有人认为尸检不太可能发现任何严重损伤。本文描述了一系列涉及车辆碰撞和坠落导致的致命钝器创伤的案例，这些案例中外部损伤极小，但内部器官却受到严重破坏。皮肤具有弹性和韧性，既能抵抗损伤，又能将相当大的力量传递到下方的肌肉骨骼系统和内部器官。因此，没有外部损伤并不等同于受力程度较轻，对于可能存在隐匿性创伤的案件，不应妨碍进行全面的法医学调查。由于卡斯珀是最早描述这一现象的人之一，当发现钝器创伤导致大量内部损伤而皮肤没有明显损伤时，或许应该使用“卡斯珀征”这一术语。
