Multishot firearm suicides are relatively rare and suggest the possibility of homicide. Physical activity following gunshots to the head, the neck, and the thorax does occur, and immediate incapacitation does not occur in every fatal gunshot wound that penetrates the head or perforates the heart. Cancer patients appear to be at increased suicide risk, but alcohol intoxication is less common in such cases. We present-to the best of our knowledge for the first time-a case of a 54-year old, male, liver cancer sufferer, who under the influence of alcohol, discharged his revolver three times, suffered, among other wounds, a heart-perforating wound, and died after c. 1.5 h, being able to talk until just before he died. Our case underlines the importance of keeping an open critical mind when dealing with multiple-gunshot fatalities, especially when posttraumatic physical activity might be crucial in differentiating homicide from suicide.
Nikolai Ivanovich Pirogov is considered one of the most important anatomists and surgeons in the history of medicine. The Russian physician conducted more than 11,000 dissections and meticulously studied human anatomy, discovering important anatomical regions such as Pirogov's triangle. Pirogov developed surgical methods and techniques used by physicians for many decades such as Pirogov's amputation. Pirogov is also known for his contribution to war medicine, given his experience practicing medicine in the Crimean War as a surgeon, where he introduced innovative methods for the treatment of injured soldiers. Pirogov’s most important contribution to the scientific community is his humanistic and democratic mentality—which he maintained until the end of his life—elements necessary for the evolution of every modern physician and scientist.
Pneumonia is an inflammatory disease of the lung parenchyma in which alveoli are filled with fluid and blood cells 1 . This condition is usually caused by viral or bacterial infections of the lung tissue, while it may also be due to aspiration of vomit or food 2 . Although the most common form of pneumonia is bacterial, lipoid pneumonia (LP) is one of the most difficult to diagnose.The case of a 44-year-old white male with unknown medical history was investigated to determine the exact cause of death. The patient was found dead and transferred to the Forensic Medical Service of Thessaloniki, where an autopsy was performed. A biopsy was done on the deceased's three key organs (heart, liver and lungs), and the most important finding was related to the lung tissue sample. We observed foci of fibrous connective tissue, swelling in specific areas, regions of hemorrhagic infiltration, plus alveoli and bronchioles destruction due to lipid deposition (Figure 1). These findings led us to consider LP as the cause of death.LP is an infectious disease of the lungs that results from entering fat into the bronchial tree 3 . There are two types of LP: exogenous and endogenous 4 . The exogenous LP occurs when the fat particles enter from outside the body and reach the lungs via the nose or mouth 5 . The endogenous LP occurs in airway obstruction. In this case, fatty particles are released from the cellular breakdown in alveolar walls, and the macrophages, which phagocytose these lipids, fill the lumen of the disconnected airspace 6 . An ill-defined, pale-yellow area on the lung reflects the gross appearance of LP. At the microscopic scale, foamy macrophages and giant cells are seen in the airways, and the inflammatory response is visible in the parenchyma 7 .In our cause, a young drug abuser died due to LP. Because of the patient's unknown medical history, we cannot confidently assume why the young man's situation led to a manifestation of LP. Nevertheless, we know that the patient was a drug addict, an essential element if we consider recent studies on pulmonary diseases of drug addicts 8 . The main reason that could lead to this case of LP is overdose. Usually, overdose leads to coma (stage 1, 2 or 3) 9 . In these stages of coma, aspiration is regularly caused due to lack
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