Fatal blunt pancreatic trauma secondary to assault and battery: a case report

Abstract

The authors report on an fatal case of closed trauma of the pancreas in a context of violence. A 55-year-old man was found unconscious on the sidewalk and died a short time after being taken to the hospital. He had been hit with several punches to the face and abdomen 6 h before. The post-mortem examination showed numerous bruises over the whole body, a haemoperitoneum, a fissuration of the spleen and a massive peripancreatic haemorrhage associated with a complete dilaceration of the pancreas head. Histological examination of the pancreas revealed a massive necrosis associated with a subtotal disappearance of the acini, numerous sites of cytosteatonecrosis and a large haemorrhagic suffusion of the peripancreatic tissue. This case illustrates the possibilities of pancreatic injuries induced by blunt force aimed at the abdomen in a context of violence. Even if this occurs as an isolated injury it can result in rapid death because of the particular type of pancreatic fracture which is frequently involved. In postmortem situations, the pancreas should be systematically checked at necropsy and a histological examination should be carried out at the slightest doubt of a pancreatic lesion or suspicion of blunt force abdominal injuries.

The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma

“…Three-fourths of all fatalities occur in the first 48-72 h [2,16,21]. The cause of sudden death is hemorrhagic shock [7,15] or extended peritonitis.…”

Mesenteric fibrosis—a histologic marker of previous blunt abdominal trauma in early childhood

“…Vascular and diaphragmatic injuries may also occur with blunt trauma [4,5]. Rupture of the liver is more likely due to a blow or a kick than to a fall on to a level surface, and similar organ injuries may occur at all ages [6,7]. Mesenteric injuries may not always be easy to diagnose in life and intraabdominal hemorrhage may rarely be due to underlying vascular malformations such as peliosis hepatis rather than to trauma [8,9].…”

Deformation characteristics of the human mandible in low impact experiments

“…The reconstruction of injuries due to blunt force is a difficult and frequent problem in legal medicine [1,2,3,4]. An increase in cases of common assault, traffic and other accidents has among other things led to an increase of mandibular fractures [5,6].…”