A new surgical method from the viewpoint of personal identification: a case of identification based on the presence of a metallic Z-stent.
To the best of our knowledge, the first case of successful personal identification based on the characteristic finding of a metallic Z-stent, unexpectedly discovered in the common bile duct, is reported. An unknown human male cadaver was found at the seaside. The age was estimated to be approximately 50-70 years and the postmortem interval was considered to be approximately 2 weeks. There was a small surgical scar of 1.5 cm in diameter in the epigastrium. The cadaver was group A in the ABO blood group system. Internally, the following severe injuries were observed: the dislocation of the occipito-atlantal joint, fractures of the cervical and thoracic portions of the spinal column, multiple fractures of the bilateral ribs, and ruptures of the spleen, left kidney and liver. Furthermore, a 4.5 cm long metallic stent was found in the common bile duct, and the gallbladder was not thoroughly identified because of the severely tight adhesion of the surrounding tissues. In every cut surface of the liver, multiple bile plaques, signifying the presence of long-standing cholestasis, were conspicuous. A microscopic examination revealed the invasion of cancer cells into the liver, which was diagnosed as well or moderately differentiated adenocarcinoma, although the primary origin of the adenocarcinoma could not be determined. The cause of his death was diagnosed as traumatic shock. According to the police investigation after the autopsy, it was revealed that a 60-year-old male, suffering from gallbladder carcinoma, had disappeared.(ABSTRACT TRUNCATED AT 250 WORDS)
Kondo
T
T
Department of Legal Medicine, Kanazawa University School of Medicine, Japan.
Ohtsuji
M
M
Ohshima
T
T
D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000601:surgery*; D017809:Fatal Outcome; D018732:Forensic Anthropology; D005554:Forensic Medicine / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000473:pathology; D011180:Postmortem Changes; D011859:Radiography; D012774:Shock, Traumatic / Q000175:diagnosis; D015607:Stents