1. Wounds “jars” By Dr / Marwa Magdy Demonstrator of forensic medicine & toxicology

2. Objectives: How to comment on jars? Description of different types of wounds. Examples : spleen, heart, liver, kidney,…

3. How to comment? 1.Specimen: jar 2.Presenting part: spleen, liver, heart, …. 3.Diagnosis: lacerated wound, stab wound, cut wound,… 4. Description of injury: Number Site Details of each type of wound( angles, edges, tissue bridging)

4. How to comment cont.? 5. Causative instrument: Blunt instrument لا تذكر إسم الألة بالتحديد ( سكينة أو Sharp instrument شومة ) 6. Complications & possible cause of death, e.g: Internal haemorrhage Shock Injury to vital organs Loss of a functioning organ

5. Description of different types of wounds 1.Cut wound: الجرح القطعى Two acute angles Regular edges No tissue bridging Caused by a sharp instrument 2. Lacerated (contused) wound: الجرج التهتكى أو الرضى Multiple angles Irregular edges Tissue bridging Caused by a blunt instrument

6. 3. Stab wound: الجرح الطعنى Has two angles 1 acute & 1 rounded→single sharp bladed. 2 acute angles→double sharp bladed Regular edges. It is deeper than longer. No tissue bridging.

7. Examples

8. Lacerated spleen

9. Specimen: jar Presenting part: spleen Diagnosis: lacerated spleen Description of injury: Multiple contused wounds on the visceral & diaphragmatic surfaces with multiple angles, irregular edges and tissue bridging. There is capsular tear. There is a subcapsular haematoma. Causative instrument: blunt trauma.

10. Complications & possible cause of death: Massive internal haemorrhage. Shock. Surgical interference. Loss of a functioning organ.

11. Stab wound in the spleen

12. Specimen: jar Presenting part: spleen Diagnosis: stab wound Description of injury: Penetrating stab wounds in the spleen Wounds are 2 in number Wounds have regular edges, one acute angle & the other rounded, gapping and no tissue bridging.

13. Causative instrument: single sharp bladed instrument Complications & possible cause of death: Internal haemorrhage Shock Injury to vital organs Loss of a functioning organ

14. Stab heart

15. Specimen: jar Presenting part: heart Diagnosis: stab wound in the heart Description of injury: Penetrating stab wound in the left ventricle with regular edges, 2 acute angles, gapping & no tissue bridging. The stab wound is deeper than longer.

16. Causative instrument: double sharp bladed instrument. Complications & possible cause of death: Massive internal haemorrhage Shock Haemopericardium & cardiac tamponade Injury to other vital organs

17. Perforated uterus

18. Specimen: jar Presenting part: uterus & fallopian tubes Diagnosis: perforated uterus Description of injury: The uterus shows 3 perforations, 2 in the fundus and 1 in the anterior wall. Causative instrument: pointed instrument Complications & possible cause of death: -Massive internal & external haemorrhage -Haemorrhagic shock Medicolegal importance MLI: this case is a suit of malpractice.

19. Lacerated wound in lung

20. Specimen: jar Presenting part: left lung Diagnosis: lacerated wound in the left lung Description of injury: The wound has irregular edges, multiple angles, tissue bridging & surrounded by contusions. Causative instrument: blunt trauma Complications & possible cause of death: Internal haemorrhage,shock,pneumothorax or haemothorax.

21. Lacerated liver

22. Specimen: jar Presenting part: left lobe of the liver Diagnosis: lacerated liver Description of injury: Avulsed left lobe of the liver showing multiple lacerated wounds with irregular edges, multiple angles, tissue bridging & surrounded by contusions. Causative instrument: blunt trauma Complications & possible cause of death: Internal haemorrhage, shock

23. Lacerated kidney

24. Specimen: jar Presenting part: left kidney Diagnosis: lacerated kidney Description of injury: The kidney shows a laceration dividing it into two parts united at the hilum by a pedicle. It has multiple angles, irregular edges & tissue bridging. Causative instrument: blunt trauma Complications: internal haemorrhage, shock, loss of a functioning organ.

25. Ante mortem cut wound

26. Specimen: jar Presenting part: part of lateral aspect of soft tissue of leg. Diagnosis: antemortem cut wound Description of injury: The wound has regular edges, acute angles, no tissue bridging. Swollen edges, gapping, blood infiltration. Causative instrument: sharp instrument Complications: haemorrhage, sepsis

27. Postmortem cut wound

28. Specimen: jar Presenting part: part of lateral aspect of soft tissue of leg. Diagnosis: postmortem cut wound Description of injury: The wound has regular edges, acute angles,no tissue bridging. Less gapping, no swollen edges, no bleeding & no vital reaction. Causative instrument: sharp instrument

29. Tentative marks

30. Specimen: jar Presenting part: skin of neck Diagnosis: tentative marks(hesitation marks) in a case of cut throat. Description: Multiple parallel superficial cut wounds. With regular edges, 2 acute angles, gapping & no tissue bridging. Complications: massive haemorrhage, shock MLI: tentative marks indicate suicidal manner of injury.

31. Thank you…..