Massive internal injury in the absence of significant external injury after collisions of passenger vehicles with much larger vehicles

Carson, Henry J.; Cook, B. A.

doi:10.1016/j.jflm.2007.10.008

Cited by 5 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A certain proportion of fatalities exhibit no external injury that appears to be fatal. A forensic autopsy of this type reveals the presence of injuries which would have remained undetected, for example, high cord injuries or rupture of major blood vessels [1,7,9]. One benefit is to make it possible, for example, to state the length of time that elapsed between the accident and death, which the casualty's family sometimes feel it is important to know.…”

Section: Discussionmentioning

confidence: 99%

The fatal injuries of car drivers

Ndiaye

Chambost²,

Chiron

2009

Forensic Science International

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

The fatal injuries of car drivers

Ndiaye

Chambost²,

Chiron

2009

Forensic Science International

View full text Add to dashboard Cite

“…Determining the extent of internal injuries from external examinations following blunt trauma is often extremely inaccurate if there are no lacerations or defects in body cavities to expose internal tissues and organs (1,2), although the nature of the injuries may be influenced by the size and age of the victims (3,4). A typical example involves adults who may have died in vehicle crashes, who may have minimal signs of injury externally, and yet who are discovered on dissection to have multifocal significant and lethal injuries to abdominal and chest organs, the brain and skull, vertebral column and rib cage.…”

Section: Discussionmentioning

confidence: 99%

“…Death was because of blunt cranial trauma. 1 Discipline of Pathology, The University of Adelaide, Frome Road, Adelaide, SA 5005, Australia.…”

Section: Casementioning

confidence: 99%

“…Prosectors have traditionally performed tests during autopsies to identify particular conditions prior to organ dissection. These include penetrating the chest cavity with a blunt probe under a water seal to check for intrapleural air in cases of pneumothorax and incising the heart under water to check for possible air embolism (1). While modern radiographic studies, utilizing computerized tomography scanning, would now be considered the preferred means for detecting these conditions, these are not always available.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Positive “Water Test”—An External Indicator of Base of Skull Hinge‐Ring Fracture

Byard

Langlois

Gilbert

2010

Journal of Forensic Sciences

View full text Add to dashboard Cite

Despite having significant internal injuries, victims of motor vehicle accidents may have surprisingly few external manifestations of trauma. The water test describes a technique whereby water placed in an upwardly facing ear results in drainage from the nose and opposite ear, thus demonstrating transcranial passage of water. This sign can be demonstrated in cases of blunt cranial trauma where there is a "hinge" fracture involving the petrous temporal bones bilaterally associated with a ring fracture extending around the foramen magnum posteriorly. Such a fracture results in separation of the posterior and middle cranial fossae providing a track for water to traverse. The water test provides a quick and noninvasive method for demonstrating the presence of a particular type of skull fracture.

show abstract

“…Even medicolegal experts face such a challenge when they are requested to examine living trauma victims or when only external postmortem examination is requested by authorities (Sah et al, 2017). This problem is particularly encountered in cases of road traffic accidents (RTAs) where severe internal injuries are caused by transmitted force while external injuries are minimal (Carson and Cook, 2008).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of External Injuries as Indicators of Internal Injuries in Victims of Blunt Trauma

Hafez

Wahdan

2021

The Egyptian Journal of Forensic Sciences and Applied Toxicolog

View full text Add to dashboard Cite

Background: Blunt trauma presents a challenge when external injuries are used to determine or predict the type and severity of internal injuries. Objective: to assess the relationship between internal injuries and external injuries in blunt trauma adult victims. Methodology: This retrospective study was conducted on adult victims of blunt trauma admitted to the Emergency hospital, Tanta University Hospitals from 1st January 2019 to 31st December 2019. Collected variables included sociodemographic data, circumstances of trauma, and sustained injuries. The Abbreviated Injury Scale (AIS) was calculated for external and internal injuries. Results: The study included 311 victims of blunt trauma. A significant association between external and internal injuries was detected in all body regions (p<0.05), but the positive predictive value (PPV) of external injury was low (below 60%) except for the neck and extremities (75% and 62.4%, respectively). The negative predictive value was ≥90% for all body regions except the head (80.6%). The correlations between AIS of external and internal injuries were positive, moderate, and significant in the neck (rs=0.668, p<0.001), extremities (rs=0.535, p<0.001), and head (rs=0.334, p<0.001), but weak in the chest (rs=0.147, p=0.009) and abdomen (rs=0.123, p=0.030). Conclusion: external injuries are considered as poor indicators of the presence of internal injuries in most body regions. Physicians should not be tempted to rule in or out the presence of internal injury based on external examination. Forensic experts should determine the extent of internal injuries based either on complete autopsy or implement the techniques of the virtual autopsy to avoid misdiagnosing significant internal injuries.

show abstract

Massive internal injury in the absence of significant external injury after collisions of passenger vehicles with much larger vehicles

Cited by 5 publications

References 5 publications

The fatal injuries of car drivers

The fatal injuries of car drivers

Positive “Water Test”—An External Indicator of Base of Skull Hinge‐Ring Fracture

Evaluation of External Injuries as Indicators of Internal Injuries in Victims of Blunt Trauma

Contact Info

Product

Resources

About