Skip to main content
SpringerLink
Log in
Book cover

Atlas of Postmortem Angiography pp 411–451Cite as

Sharp Trauma

  • Chapter
  • First Online:

Abstract

Sharp trauma injuries are inflicted by different kinds of tools, but definitely the most popular crime weapon in such cases is the knife. Cut wounds and stab wounds are mainly related to suicides and homicides. In a considerable number of cases, a combination of both cut and stab wounds can be inflicted by the change of the weapon position while it is inside the body. Incised wounds are mostly related to self-inflicted injuries. In contrast, a case with stab wounds is more likely to be a homicide. Depending on the geographic area, stab wounds can be the most common homicidal injuries, especially in domestic homicide cases. A detailed and objective autopsy report has great value in documenting a case, particularly in a homicide investigation. By using postmortem imaging to show important aspects of findings, we have the opportunity to improve the reconstruction and understanding of the event. To visualize multiple stab wounds and the injuries that they have caused, whole body angiography techniques are valuable tools. Today’s most commonly applied technique of multiphase postmortem CT angiography (MPMCTA) can enhance visualization of soft-tissue damage and is useful for locating internal organs and blood vessel injuries, which can be important for estimating an injury track. Additionally, with application of this standardized technique, the trajectory of stab wounds can be directly visualized by the enhancement provided by the injected contrast agent. Therefore, this approach is applied regularly with such cases in our centers. This chapter illustrates the use and performance of MPMCTA in investigating cases of sharp trauma.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Lew E, Matshes E. Sharp force injuries. In: Dolinak D, Matsches E, Lew E, editors. Forensic pathology: principles and practice. Philadelphia: Elsevier Academic Press; 2005. p. 143–62.

    Google Scholar 

  2. Shepherd R. The examination of wounds. In: Shepherd R, editor. Simpson’s forensic medicine. 12th ed. London: Arnold; 2003. p. 59–69.

    Google Scholar 

  3. Hainsworth SV, Delaney RJ, Rutty GN. How sharp is sharp? Towards quantification of the sharpness and penetration ability of kitchen knives used in stabbings. Int J Legal Med. 2008;122:281–91.

    Article  CAS  PubMed  Google Scholar 

  4. Assunção LA, Santos A, Magalhães T. Suicide by sharp force injuries—a study in Oporto. Leg Med (Tokyo). 2009;11 Suppl 1:S216–9.

    Article  Google Scholar 

  5. Bloch-Bogusławska E, Wolska E, Engelgardt P, Pufal E. [Cases of homicide-suicide (post-aggression suicide) in the material of the Chair and Department of Forensic Medicine in Bydgoszcz]. Arch Med Sadowej Kryminol. 2006;56:169–72. [Polish].

    PubMed  Google Scholar 

  6. Bolechała F, Polewka A, Trela F, Zięba A, Kołodziej J. [Male and female suicides in the material of Department of Forensic Medicine in Krakow—comparative analysis]. Arch Med Sadowej Kryminol. 2003;53:301–11. [Polish].

    PubMed  Google Scholar 

  7. De-Giorgio F, Lodise M, Quaranta G, Spagnolo AG, d’Aloja E, Pascali VL, Grassi VM. Suicidal or homicidal sharp force injuries? A review and critical analysis of the heterogeneity in the forensic literature. J Forensic Sci. 2015;60 Suppl 1:S97–107.

    Article  PubMed  Google Scholar 

  8. Edirisinghe PA, Kitulwatte ID. Extreme violence-homicide: an analysis of 265 cases from the offices of JMO Colombo and Ragama—a study from Sri Lanka. Leg Med (Tokyo). 2009;11 Suppl 1:S363–5.

    Google Scholar 

  9. Hata N, Kominato Y, Shimada I, Takizawa H, Fujikura T, Morita M, et al. Regional differences in homicide patterns in five areas of Japan. Leg Med (Tokyo). 2001;3:44–55.

    Article  CAS  Google Scholar 

  10. Inokuchi G, Ishihara K, Hayakawa M, Yajima D, Makino Y, Motomura A, et al. Trends in forensic autopsy in Chiba prefecture over the past decade. Leg Med (Tokyo). 2014;16:258–63.

    Article  Google Scholar 

  11. Schindler T, Dettmeyer RB, Wollersen H. [Cause and manner of death in the autopsy material of the Institute of Forensic Medicine, Justus Liebig University Giessen, from 2002–2006]. Arch Kriminol. 2014;234:10–8. [German].

    PubMed  Google Scholar 

  12. Konopka T, Bolechała F, Strona M. Chest stab wound comparison in suicidal and homicidal cases. Arch Med Sadowej Kryminol. 2003;53:117–28. [Polish].

    PubMed  Google Scholar 

  13. Konopka T. Lethal injuries caused by sharp tools. Arch Med Sadowej Kryminol. 2004;54:79–84. [Polish].

    PubMed  Google Scholar 

  14. Karger B, Niemeyer J, Brinkmann B. Suicides by sharp force: typical and atypical features. Leg Med (Tokyo). 2000;113:259–62.

    CAS  Google Scholar 

  15. Kunz J, Strona M. Atypical cases of suicides. Arch Med Sadowej Kryminol. 2003;53:185–91. [Polish].

    Google Scholar 

  16. Fracasso T, Karger B. Two unusual stab injuries to the neck: homicide or self-infliction? Int J Legal Med. 2006;120:369–71.

    Article  CAS  PubMed  Google Scholar 

  17. Pfeiffer H, Fechner G, Brinkmann B. Backstabbing—a report of an unusual case. Int J Legal Med. 2005;119:47–9.

    Article  CAS  PubMed  Google Scholar 

  18. Schmidt U, Faller-Marquardt M, Tatschner T, Walter K, Pollak S. Cuts to the offender’s own hand--unintentional self-infliction in the course of knife attacks. Int J Legal Med. 2004;118:348–54.

    Article  PubMed  Google Scholar 

  19. Karger B, Niemeyer J, Brinkmann B. Physical activity following fatal injury from sharp pointed weapons. Int J Legal Med. 1999;112:188–91.

    Article  CAS  PubMed  Google Scholar 

  20. Myers JC, Okoye MI, Kiple D, Kimmerle EH, Reinhard KJ. Three-dimensional (3-D) imaging in postmortem examinations: elucidation and identification of cranial and facial fractures in victims of homicide utilizing 3D computerized imaging reconstruction techniques. Int J Legal Med. 1999;113:33–7.

    Article  CAS  PubMed  Google Scholar 

  21. Thali MJ, Dirnhofer R, Vock P, editors. The virtopsy approach: 3D optical and radiological scanning and reconstruction in forensic medicine. Boca Raton: CRC Press; 2009.

    Google Scholar 

  22. Thali MJ, Viner M, Brogdon BG, editors. Brogdon’s forensic radiology. 2nd ed. Boca Raton: CRC Press; 2011.

    Google Scholar 

  23. Christe A, Flach P, Ross S, Spendlove D, Bolliger S, Vock P, Thali MJ. Clinical radiology and postmortem imaging (Virtopsy) are not the same: specific and unspecific postmortem signs. Leg Med (Tokyo). 2010;12:215–22.

    Article  Google Scholar 

  24. Filograna L, Thali MJ, Marchetti D. Forensic relevance of postmortem CT imaging of the haemopericardium in determining the cause of death. Leg Med (Tokyo). 2014;16:247–51.

    Article  Google Scholar 

  25. Oesterhelweg L, Ross S, Spendlove D, Schoen CA, Christe A, Thali MJ, Bolliger SA. Virtopsy: fatal stab wounds to the skull – the relevance of ante-mortem and postmortem radiological data in case reconstructions. Leg Med (Tokyo). 2007;9:314–7.

    Article  CAS  Google Scholar 

  26. Schnider J, Thali MJ, Ross S, Oesterhelweg L, Spendlove D, Bolliger SA. Injuries due to sharp trauma detected by postmortem multislice computed tomography (MSCT): a feasibility study. Leg Med (Tokyo). 2009;11:4–9.

    Article  CAS  Google Scholar 

  27. Germerott T, Preiss US, Ross SG, Thali MJ, Flach PM. Postmortem ventilation in cases of penetrating gunshot and stab wounds to the chest. Leg Med (Tokyo). 2013;15:298–302.

    Article  Google Scholar 

  28. Bolliger SA, Preiss U, Glaeser N, Thali MJ, Ross S. Radiological stab wound channel depiction with instillation of contrast medium. Leg Med (Tokyo). 2010;12:39–41.

    Article  CAS  Google Scholar 

  29. Leth PM, Stolborg U. Computed tomography of contrast-filled stab wounds in various tissue types. J Foren Radiol Imag. 2013;1:79.

    Article  Google Scholar 

  30. Chevallier C, Doenz F, Vaucher P, Palmiere C, Dominguez A, Binaghi S, et al. Postmortem computed tomography angiography vs. conventional autopsy: advantages and inconveniences of each method. Int J Legal Med. 2013;127:981–9.

    Article  PubMed  Google Scholar 

  31. Ruder TD, Ketterer T, Preiss U, Bolliger M, Ross S, Gotsmy WF, et al. Suicidal knife wound to the heart: challenges in reconstructing wound channels with post mortem CT and CT-angiography. Leg Med (Tokyo). 2011;13:91–4.

    Article  Google Scholar 

  32. Moskała A, Woźniak K, Kluza P, Bolechała F, Rzepecka-Woźniak E, Kołodziej J, Latacz K. Validity of postmortem computed tomography angiography (PMCTA) in medico-legal diagnostic management of stab and incised wounds. Arch Med Sadowej Kryminol. 2012;62:315–26. [Polish].

    PubMed  Google Scholar 

  33. Grabherr S, Grimm J. Multiphase postmortem CT – angiography (MPMCTA): a new method for investigating violent death. In: Vogel B, Vogel H, editors. Forensics, radiology, society, x-rays: tool and document. Hamburg: Dr. Kovač Verlag; 2014. p. 156–63.

    Google Scholar 

  34. Hirt M, Karger B. Fatal brain injury caused by the free-flying blade of a knife—case report and evaluation of the unusual weapon. Int J Legal Med. 1999;112:313–4.

    Article  CAS  PubMed  Google Scholar 

  35. Cerutti E, Magli F, Porta D, Gibelli D, Cattaneo C. Metrical assessment of cutmarks on bone: is size important? Leg Med (Tokyo). 2014;16:208–13.

    Article  CAS  Google Scholar 

  36. Gaudio D, Di Giancamillo M, Gibelli D, Galassi A, Cerutti E, Cattaneo C. Does cone beam CT actually ameliorate stab wound analysis in bone? Int J Legal Med. 2014;128:151–9.

    Article  CAS  PubMed  Google Scholar 

  37. Rubinacci A, Tresoldi D, Villa I, Rizzo G, Gaudio D, De Angelis D, et al. Application of high resolution pQCT analysis for the assessment of a bone lesion: a technical note. Leg Med (Tokyo). 2015;17:60–4.

    Article  CAS  Google Scholar 

  38. Woźniak K, Moskała A, Konopka T, Rzepecka-Woźniak E, Bolechała F, Kluza P, Latacz K. Application of PMCT in cases of deaths potentially caused by tension pneumothorax. J Foren Radiol Imag. 2013;1:87.

    Article  Google Scholar 

  39. Ebner L, Flach PM, Schumann K, Gascho D, Ruder T, Christe A, et al. The tip of the tip of the knife: stab sequence reconstruction using postmortem CT in a homicide case. J Foren Radiol Imag. 2014;2:205–9.

    Article  Google Scholar 

  40. Konopka T, Strona M, Bolechała F, Kunz J. Corpse dismemberment in the material collected by the Department of Forensic Medicine, Cracow, Poland. Leg Med (Tokyo). 2007;9:1–13.

    Article  Google Scholar 

Download references

Acknowledgement

The authors’ PMCTA research was approved by the appropriate University Bioethics Committee (KBET/225/B/2012).

Author information

Authors and Affiliations

  1. Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Grzegórzecka 16, 31–531, Kraków, Poland

    Krzysztof Jerzy Woźniak MD, PhD & Artur Moskała MD

  2. University Center of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland

    Silke Grabherr MD, PhD

Authors
  1. Krzysztof Jerzy Woźniak MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Artur Moskała MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Silke Grabherr MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Krzysztof Jerzy Woźniak MD, PhD .

Editor information

Editors and Affiliations

  1. University Center of Legal Medicine, Lausanne, Switzerland

    Silke Grabherr

  2. University Center of Legal Medicine, University Hospital Center Vaudois, Lausanne, Switzerland

    Jochen M. Grimm

  3. Institute of Legal Medicine, University Medical Center Hamburg-Eppend, Hamburg, Germany

    Axel Heinemann

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Woźniak, K.J., Moskała, A., Grabherr, S. (2016). Sharp Trauma. In: Grabherr, S., Grimm, J., Heinemann, A. (eds) Atlas of Postmortem Angiography. Springer, Cham. https://doi.org/10.1007/978-3-319-28537-5_27

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-28537-5_27

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28535-1

  • Online ISBN: 978-3-319-28537-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation