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尸体肢解:病例系列。通过综合多学科方法解决难题。

Corpse dismemberment: A case series. Solving the puzzle through an integrated multidisciplinary approach.

机构信息

Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185, Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, Italy.

Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185, Rome, Italy.

出版信息

J Forensic Leg Med. 2020 Aug;74:102005. doi: 10.1016/j.jflm.2020.102005. Epub 2020 Jul 7.

Abstract

The finding of corpse parts poses several challenges for the forensic pathologist presenting implications for identification, diagnosis of death and determination of wounds vitality. Further interpretative difficulties in cases of cadaveric dismemberment derive from the scarcity of tanatochronological parameters useful to estimate the post-mortem interval (PMI) and the absence of uniform investigative protocols in the different centres of forensic pathology. The present study proposes an investigation protocol for the cadaveric dismemberment through the discussion of a case series. The study group consisted of cases in which the dismemberment was performed after the murder. For all cases, a study protocol based on crime scene investigation, post-mortem computed tomography (PMCT), autopsy, toxicological, histological, immunohistochemical and genetic investigations was implemented. In particular, the standardised use of radiographic study before the autopsy allows all to have information that can guide the forensic pathologist during the autopsy. The use of immunohistochemistry allows an assessment of the vitality of the lesions possibly involved in the determinism of death, as well as of the surfaces of dismemberment, representing a tool of considerable utility for forensic purposes. The genetic investigations allow the identification of the victims, while the toxicological ones highlight the possible abuse of substances. The implemented protocol presents a demonstrated usefulness in improving diagnostic accuracy in corpse dismemberment cases.

摘要

发现尸体部位给法医病理学家提出了几个挑战,这些挑战涉及身份识别、死亡诊断和伤口活力判断。在尸体肢解的情况下,进一步的解释困难源于对死后间隔时间(PMI)进行估计的 tanatochronological 参数的稀缺,以及法医病理学不同中心缺乏统一的调查方案。本研究通过讨论一系列案例提出了一种针对尸体肢解的调查方案。研究组包括在谋杀后进行肢解的案例。对于所有案例,都实施了基于犯罪现场调查、死后计算机断层扫描(PMCT)、尸检、毒理学、组织学、免疫组织化学和遗传研究的研究方案。特别是,在尸检前标准化使用放射学研究可以为法医病理学家提供指导。免疫组织化学的使用可以评估可能涉及死亡决定的病变的活力,以及肢解的表面,这是一种对于法医目的具有相当实用价值的工具。遗传研究允许识别受害者,而毒理学研究则强调了物质滥用的可能性。实施的方案在提高尸体肢解案件的诊断准确性方面具有明显的实用性。

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