We present two cases of nearly total skeletization of the exposed face and neck due to indoor postmortem animal interference and a review of the literature. In the case of a 61-year-old man, inspection of the damaged soft tissue margins revealed serrated edges and parallel cutaneous lacerations caused by rats. In the case of a 40-year-old woman, postmortem examination revealed v-shaped and rhomboid-shaped tunneled wounds in the damaged soft tissue caused by a pit bull terrier. The autopsy in both cases identified natural causes of death. While the morphological feature of postmortem soft tissue artifacts caused by rodents can be ascribed to animal incisors, stab wound-like punctured wounds are characteristic of canine dentition of carnivorous origin. Additional morphological criteria for injuries of carnivorous origin are linear scratch-type abrasions from claws in the vicinity of the injuries. In cases of indoor postmortem animal interference damage is primarily caused to the exposed areas of the body, no self-defense injuries can be found on the deceased's body, only a small amount of blood or the total absence of bloodstains should be expected at the scene, an inquiry of pets living free in the house or wild animals having possible access to the scene should be conducted and rodent excrement found at the scene can give the investigator further information.

The so-called “Postcholecystectomy Syndrome” may be due to various pathological biliary causes. The aim of this study was to evaluate the significance of the cystic duct stump syndrome and if so, how often a long (>1.5 cm) cystic duct stump was an indication for reoperation on the bile ducts after cholecystectomy in our patients. Three hundred and twenty two patients underwent a second operation on the bile ducts after cholecystectomy in the last ten years. In 35 patients (10.8%) a striking finding was a long cystic duct stump (>1.5 cm). In 24 of these patients, a pathological finding, in addition to the long cystic duct stump, was found on exploration. Out of these 24 patients there were 14 with common bile duct stones; 6 with stenosis of the sphincter of Oddi; 3 with chronic pancreatitis and in one patient hepatitis was the cause of the symptoms. From the remaining 11 patients 8 had a stone in a partial gall bladder or cystic duct stump. One patient had a fistula between the cystic duct stump and duodenum and one a suture granuloma. There was only one patient where a 1.5 cm long cystic duct stump remnant was the only pathological finding. Four years after reoperation this patient is still suffering from the same intermittent gastrointestinal symptoms. We conclude that the cystic duct stump is hardly ever a cause for recurrent symptoms in itself. Total excision of the cystic duct does not eliminate the existence of postcholecystectomy symptoms.

No abstract

In a prospective autopsy series of 39 cases of fatal drowning, the detailed dissection of the skeletal muscles of the neck, anterior/posterior trunk and the upper extremities in layers revealed intramuscular hemorrhages of different size and shape in 20 cases (51.3%). Light microscopy examination showed a premortal (vital/agonal) type of muscular alteration in 7 (50%) out of 14 macroscopical hemorrhage-positive cases. These hemorrhages and histological muscle alterations are attributed to agonal convulsions, hypercontraction and overexertion of the affected muscle groups. As long as no cutaneous or subcutaneous hematomas above the hemorrhages can be found, these autopsy findings (with special reference to histology) can serve as an additional criterion concerning the differentiation of drowning and another cause of death.

A 34-year-old heroin addict in the eighth month of pregnancy was found dead in her apartment. The head of a fetus was partly protruding from underneath the woman's slip. At the time of autopsy, the body was in a state of advanced putrefaction with greenish discoloration of almost the complete body surface showing pronounced marbling and, in addition, now not only the head but also the upper part of the chest of a dead fetus were extruding from the birth canal with head presentation. Autopsy showed no signs of external violence prior to death and, in particular, no indication of preceding manipulations in the region of the obstetrical canal and the uterus could be detected. The uterine cavity showed pronounced putrefactive alterations with the amniotic membranes being partially raised and bloated in a balloon-like fashion. Toxicological analyses revealed acute heroin intoxication of mother and child. The immature neonate showed no signs of live birth. Pathogenetically, the finding of not only the head but also the upper part of the chest of the fetus extruding from the birth canal at the time of autopsy (contrary to the observation made at the death scene that only part of the head of the fetus was protruding) is consistent with post-mortem fetal extrusion caused by putrefactive gas pressure against the pregnant uterus as reported in the earlier German forensic pathological literature.