Singh Arwinder, S Yashpal, Vaishnav Dilip, S Kishanth, Jangid Amit
Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Cureus. 2025 Jul 4;17(7):e87269. doi: 10.7759/cureus.87269. eCollection 2025 Jul.
The sternum develops from multiple ossification centers, and their incomplete fusion can lead to congenital anomalies like sternal foramina; although typically asymptomatic, these foramina possess significant clinical and forensic relevance due to their potential mimicry of penetrating traumatic injuries such as gunshot wounds. We present a forensic case involving a highly decomposed body, recovered from a submerged vehicle two years post-incident, which exhibited a distinct sternal defect initially suspected as a gunshot wound based on its location and appearance. However, meticulous skeletal examination revealed features consistent with a congenital sternal foramen, including smooth, well-corticated margins and uniform defect dimensions, which allowed for the exclusion of trauma due to the absence of typical gunshot wound characteristics like bevelling, radiating fractures, and bone fragmentation. This case crucially highlights the importance for forensic pathologists to recognize and accurately differentiate anatomical variants like sternal foramina, thereby preventing misinterpretation of the cause and manner of death and ensuring accurate medico-legal conclusions.
胸骨由多个骨化中心发育而来，这些骨化中心融合不完全可导致先天性异常，如胸骨孔；尽管通常无症状，但这些胸骨孔因其可能被误认为穿透性创伤，如枪伤，而具有重要的临床和法医意义。我们报告一例法医案件，涉及一具高度腐败的尸体，在事件发生两年后从一辆沉没的车辆中找到，该尸体有一个明显的胸骨缺损，根据其位置和外观，最初怀疑是枪伤。然而，细致的骨骼检查发现了与先天性胸骨孔一致的特征，包括边缘光滑、皮质良好以及缺损尺寸均匀，由于没有如斜面、放射状骨折和骨碎片等典型枪伤特征，因此排除了创伤的可能。该案例着重强调了法医病理学家识别并准确区分胸骨孔等解剖变异的重要性，从而避免对死亡原因和方式的错误解读，并确保得出准确的法医学结论。
