Klein Anke, Schröder Carolin, Heinemann Axel, Püschel Klaus
Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany,
Forensic Sci Med Pathol. 2014 Sep;10(3):437-42. doi: 10.1007/s12024-014-9554-7. Epub 2014 Apr 13.
Determining the cause of death and differentiating self-inflicted injuries from non-self-inflicted injuries is a primary goal in legal medicine. Especially with unidentified decedents, autopsy findings alone are often not sufficient; there is no knowledge of pre-existing conditions and only circumstantial evidence is available from the scene of death. In our case, radiological, histological, and toxicological examinations provided an explanatory model for extraordinary autopsy findings consistent with pica, a rare eating disorder. In cases of pica, variable and potentially lethal complications emerge, depending on the type and amount of material ingested. Our case is of an apparently uncontrolled intake of wooden objects (xylophagia). The resulting mechanical damage to the gastrointestinal tract and subsequent soft tissue damage supports that this behavioral disorder is not only of medical concern, but also identifies it as a mental disease with medico-legal relevance.
确定死因并区分自伤与非自伤是法医学的主要目标。特别是对于身份不明的死者，仅靠尸检结果往往是不够的；对死者生前存在的疾病情况一无所知，且仅能从死亡现场获取间接证据。在我们这个案例中，放射学、组织学和毒理学检查为与异食癖（一种罕见的进食障碍）相符的异常尸检结果提供了一个解释模型。在异食癖病例中，根据摄入物质的类型和数量会出现各种潜在致命并发症。我们的案例是明显无节制地摄入木质物品（食木癖）。由此导致的胃肠道机械性损伤及随后的软组织损伤表明，这种行为障碍不仅关乎医学领域，还将其认定为具有法医学意义的精神疾病。
