Forensic Features of Lethal Late‐Presenting Diaphragmatic Hernias. Issue 5 (22nd June 2016)

• Record Type: Journal Article
• Authors: Thompson, Melissa; Wills, Stephen; Byard, Roger W.
• Is Part Of: Journal of forensic sciences. Volume 61:Issue 5(2016)
• Page Start: 1261
• Page End: 1265
• Publication Date: 2016-06-22
• Subjects: forensic science -- diaphragm -- hernia -- perforation -- lung compression -- death; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; 363.2505
• DOI: 10.1111/1556-4029.13142
• Languages: English
• ISSNs: 0022-1198

Abstract

Abstract: Diaphragmatic defects are a relatively common and benign finding in adults which may be congenital or secondarily acquired. The case files at Forensic Sciences South Australia were reviewed over a 10‐year period from July 2005 to June 2015 for all adult (>17 years) cases in which diaphragmatic hernias were identified at postmortem examination that had either caused or contributed to death. Five cases were found: age range 49–90 years (average 67.2 years); male:female ratio 2:3. Herniated organs included the stomach ( N = 3), small ( N = 3) and large intestines ( N = 2). Mechanisms of death involved lung compression with respiratory failure and/or mediastinal shift, and vascular compromise with gastric or intestinal infarction and/or perforation. Diaphragmatic hernias may not be identified until the time of autopsy and may be quite complex entities to evaluate due to a lack of clinical history and to difficulties in determining their origin and possible contributions to mechanisms of death.