Sultan Ahmad Shah Medical Centre @International Islamic University Malaysia, Department of Pathology and Laboratory Medicine (PALM), Forensic Unit, Pahang, Malaysia.
Malays J Pathol. 2024 Aug;46(2):331-337.
Electrocution related death remains an ambiguous judgement and requires numerous valid evidence for proper medico-legal diagnosis. While the presence of electrical burn marks is a significant macroscopic indicator, it can be absent, especially on moist skin. The electrical mark still represents a fundamental indicator above all in the medico-legal field, but the identification of pathognomonic elements and signs not limited to the skin alone could be a valid help in the future, especially in unclear cases.
The deceased was brought-in-dead to the hospital from their workplace, with no signs of fatal natural diseases. External examination revealed a Y-shaped burn mark on the right side of the neck and collapsed blisters with greying rings on both heels. Internal examination showed no alarming findings. Further, histopathological analysis of the foot blisters and neck burn revealed intraepidermal detachment, elongated nuclei, and coagulative necrosis. Notably, the presence of muscle fibre casts in kidney tubules and microthrombi in lung sections which indicate rhabdomyolysis and vascular thrombosis supported electrocution-related death.
These positive findings of the electrical burn marks externally and significant histopathological changes, collectively support the death was due to electrocution, after excluding any major, fatal injuries. Albeit, a detailed inspection of the crime scene plays an important role, in order to classify the electrocution related death.
电击相关的死亡仍然是一个模糊的判断,需要大量有效的证据来进行适当的法医诊断。虽然存在电气烧伤痕迹是一个重要的宏观指标,但它可能不存在,尤其是在潮湿的皮肤上。电气痕迹仍然是法医学领域的基本指标,但识别不仅限于皮肤的特征性元素和迹象,将来可能会有所帮助,尤其是在不明确的情况下。
死者从工作场所被送进医院时已经死亡,没有致命的自然疾病迹象。外部检查显示颈部右侧有 Y 形烧伤痕迹,两个脚跟有塌陷的水疱和灰环。内部检查没有发现异常。此外,脚部水疱和颈部烧伤的组织病理学分析显示表皮内分离、拉长的细胞核和凝固性坏死。值得注意的是,肾小管中存在肌纤维铸型和肺切片中的微血栓,表明横纹肌溶解和血管血栓形成,支持电击致死。
这些外部电气烧伤痕迹的阳性发现以及显著的组织病理学变化,共同支持在排除任何重大致命伤害后,死亡是由于电击所致。尽管如此,对犯罪现场进行详细检查对于分类电击相关的死亡仍然很重要。