Osculati Antonio, Visonà Silvia Damiana, Re Laura, Sozzi Marta, Castelli Francesca, Andrello Luisa, Vignali Claudia
Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences "Antonio Fornari", University of Pavia, Pavia, Italy.
Unit of Legal Medicine, University of Insubria, Varese, Italy.
Int J Legal Med. 2017 May;131(3):719-722. doi: 10.1007/s00414-016-1521-2. Epub 2016 Dec 24.
The authors present a case which brings out a unique modality of child homicide by placing the baby in a washing machine and turning it on. The murder was perpetrated by the baby's mother, who suffered from a serious depressive disorder. A postmortem RX and then a forensic autopsy were performed, followed by histologic examinations and toxicology. On the basis of the results of the autopsy, as well as the histology and the negative toxicological data, the cause of death was identified as acute asphyxia. This diagnosis was rendered in light of the absence of other causes of death, as well as the presence of typical signs of asphyxia, such as epicardial and pleural petechiae and, above all, the microscopic examinations, which pointed out a massive acute pulmonary emphysema. Regarding the cause of the asphyxia, at least two mechanisms can be identified: drowning and smothering. In addition, the histology of the brain revealed some findings that can be regarded as a consequence of the barotrauma due to the centrifugal force applied by the rotating drum of the washing machine. Another remarkable aspect is that we are dealing with a mentally-ill assailant. In fact, the baby's mother, after a psychiatric examination, was confirmed to be suffering from a mental illness-a severe depressive disorder-and so she was adjudicated not-guilty-by-reason-of-insanity. This case warrants attention because of its uniqueness and complexity and, above all, its usefulness in the understanding of the pathophysiology of this particular manner of death.
作者介绍了一个案例，该案例呈现了一种独特的儿童杀人方式，即把婴儿放进洗衣机并开启洗衣机。凶手是婴儿的母亲，她患有严重的抑郁症。进行了尸检X光检查，随后进行法医解剖，接着是组织学检查和毒理学检测。根据尸检结果、组织学检查以及阴性毒理学数据，死亡原因被确定为急性窒息。做出这一诊断是鉴于不存在其他死亡原因，以及存在窒息的典型迹象，如心外膜和胸膜瘀点，最重要的是，显微镜检查显示有大量急性肺气肿。关于窒息的原因，至少可以确定两种机制：溺水和闷死。此外，大脑的组织学检查发现了一些可被视为洗衣机旋转滚筒施加的离心力导致气压伤后果的情况。另一个值得注意的方面是，我们面对的是一名精神疾病攻击者。事实上，婴儿的母亲经过精神病检查，被确诊患有精神疾病——严重的抑郁症——因此她被判定因精神错乱而无罪。由于该案例的独特性和复杂性，尤其是在理解这种特殊死亡方式的病理生理学方面的实用性，它值得关注。
