Cascini Fidelia, Biondo Domenico, Giannace Carolina, Filograna Laura, Laino Domenico, Capelli Arnaldo, Pascali Vincenzo L
Istituto di Sanità Pubblica, sezione di Medicina Legale, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Roma, Italy.
J Forensic Sci. 2019 Jul;64(4):1234-1237. doi: 10.1111/1556-4029.13957. Epub 2018 Nov 16.
History of neck trauma should be promptly investigated in patients with severe infections of the chest as mediastinitis. We present a forensic case of a death due to a mediastinitis in a patient with an undetected fracture of the superior horn of the thyroid cartilage that was exclusively revealed at autopsy examination. Histological analyses of the neck tissues showed signs of pharyngeal mucosal microperforation caused by the fracture and surrounded by an inflammatory reaction. The fracture was caused by a not declared manual strangulation attempt, happened several days before medical evaluations. We share our experience to emphasize the importance of revealing the etiologies of fatal infections of the mediastinum both for clinical and forensic purposes.
对于患有如纵隔炎等严重胸部感染的患者，应立即调查其颈部创伤史。我们报告一例法医学案例，一名患者因纵隔炎死亡，尸检时才发现其甲状软骨上角骨折，此前一直未被察觉。颈部组织的组织学分析显示，骨折导致咽黏膜微穿孔，并伴有炎症反应。骨折是由一次未申报的手动勒颈企图引起的，发生在医疗评估前几天。我们分享这一经验，以强调揭示纵隔致命感染病因对于临床和法医目的的重要性。
