Studies on Morphological Changes of Organs due to Traumatic Shock

1991 Fiscal Year Final Research Report Summary

• Project/Area Number: 02670256
• Research Category: Grant-in-Aid for General Scientific Research (C)
• Allocation Type: Single-year Grants
• Research Field: Legal medicine
• Research Institution: Gifu University
• Principal Investigator: OHYA Isao Gifu University School of Medicine Professor Department of Legal Medicine, 医学部, 教授 (80021393)
• Co-Investigator(Kenkyū-buntansha): BUNAI Yasuo Gifu University School of Medicine Associate Professor Department of Legal Medic, 医学部, 助教授 (50165510)
• Project Period (FY): 1990 – 1991
• Keywords: Traumatic Shock / Lung / Polymorphoneutophil / Adrenal Gland / Adrenal Cortical Necrosis / Heart / Degenerative Cardiac Myocyte / Medicolegal Autopsy Cases

Research Abstract

The lung, adrenal gland and heart were studied pathologically to reveal their characteristic shock-related changes, using medicolegal autopsy cases. Pathological studies of the lung, using 103 cases, revealed that pulmonary edema, hemorrhage or congestion was a non-specific finding. However, if polymorphoneutrophiles (PMN) in the alveolar capillaries were counted and a case in which PMN/alveolus ratio was over 1 was determined positive, cases sustained by hemorrhage, head injuries and cardiac tamponade, and cases in which deaths occurred in a state of shock showed relatively high incidence of positive cases, 56%, 43%, 40% and 55%, respectively. On the other hand, cases sustained by asphyxia and cases dead by fire revealed negative. Moreover, PMN increased also in cases sustained by strong blunt force and cases sustained by stab and/or incised wounds, 50% and 71%, respectively. Thus, increase of PMN occurs shortly after receiving injuries and can become one of the important findings to reveal pathological aspects in medicolegal autopsy cases. In a study of the adrenal gland using 60 autopsy cases which showed a little postmortem changes, adrenal cortical necrosis was observed in cases sustained by head injuries and hemorrhage, and cases in which deaths occurred in s state of shock, 50%, 31% and 50%, respectively. Thus, adrenal cortical necrosis can be also considered one of the important findings which occurs sortly after receiving injuries. So far as the heart, 10 cases in which deaths occurred in a state of shock were mainly examined. Diffuse staining of the cardiac myocyte was observed in 7 cases and contraction bands necrosis was observed in 5 cases. Thus, these findings are considered important ones which occur shortly after injuries and explain pathological condition of the heart in medicolegal autopsy cases.