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揭开谜团:疑似蛇咬伤死亡的尸检挑战。

Unravelling the enigma: Autopsy challenges in alleged snakebite deaths.

机构信息

Department Forensic Medicine and Toxicology, AIIMS Bhopal, Madhya Pradesh, India.

Department of Pathology, AIIMS Bhopal, Madhya Pradesh, India.

出版信息

Forensic Sci Int. 2024 Nov;364:112228. doi: 10.1016/j.forsciint.2024.112228. Epub 2024 Sep 10.

Abstract

Snakebites account for a substantial public health burden in India, contributing to 80 % of global snakebite fatalities. This case series explores the intricacies of two alleged neurotoxic snakebite deaths, delving into the complexities of diagnosing neurotoxic snakebite deaths in India through meticulous medico-legal autopsies. Despite initial suspicions and circumstantial evidence suggesting snakebite involvement, the autopsies revealed surprising causes of death. The article discusses challenges in accurately attributing deaths to snakebites, and the potential for false claims, and underscores the crucial role of Forensic pathologists in dispelling enigmas. Forensic pathologists are urged to maintain an unbiased approach, allowing postmortem findings to guide conclusions amidst deliberate attempts to mislead. The cases described highlight that ruling out snake bites in cases with positive history is as challenging as opining a case of neurotoxic snake bite as they are mainly the diagnosis of exclusion in autopsy.

摘要

在印度,蛇咬伤导致了相当大的公共卫生负担,占全球蛇咬伤死亡人数的 80%。本病例系列探讨了两起疑似神经毒性蛇咬伤死亡的复杂性,通过细致的法医解剖深入研究了在印度诊断神经毒性蛇咬伤死亡的复杂性。尽管最初的怀疑和间接证据表明涉及蛇咬伤,但尸检揭示了令人惊讶的死因。本文讨论了准确将死亡归因于蛇咬伤的挑战,以及虚假索赔的可能性,并强调了法医病理学家在消除谜团方面的关键作用。敦促法医病理学家保持公正的态度,让尸检结果在蓄意误导的情况下指导结论。所描述的病例表明,在有阳性病史的情况下排除蛇咬伤的难度与推断神经毒性蛇咬伤的病例一样大,因为在尸检中主要是排除性诊断。

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