title: The discrepant severity of external and internal injuries in a traffic accident: The cushioning effect via a human body against direct impact: Autopsy cases.
abstract: Traffic accidents cause unexpectedly severe injuries of internal organs despite tiny injuries observed on the external body. A 51-year-old woman (subject 1) and a 54-year-old man (subject 2) were found dead on a road. Subject 1 had subcutaneous and intramuscular bleeding with décollement on the posterior aspect of her body, including upper cervical spine dislocation. Subject 2 did not exhibit any apparent findings on autopsy that were indicative of a direct injury by a motor vehicle, but had severe internal organ injuries, including the transection at the pontomedullary junction. We surmise that subjects 1 and 2 were walking in line with the vehicle which collided with them from behind, and then the body of subject 1 cushioned the direct impact of the vehicle against subject 2. This report illustrates the need of forensic autopsy for victims with no severe external injuries.
authors.affiliation: Department of Legal Medicine, Sapporo Medical University School of Medicine, Japan. nyoko@sapmed.ac.jp
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nishitani
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Okazaki
authors.forename: Kengo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Imabayashi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Katada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsumoto
mesh_terms: D000063:Accidents, Traffic; D020212:Carotid Artery Injuries / Q000473:pathology; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D050723:Fractures, Bone / Q000473:pathology; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D004204:Joint Dislocations / Q000473:pathology; D008099:Liver / Q000293:injuries / Q000473:pathology; D008159:Lumbar Vertebrae / Q000293:injuries / Q000473:pathology; D008297:Male; D008526:Medulla Oblongata / Q000293:injuries / Q000473:pathology; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D011149:Pons / Q000293:injuries / Q000473:pathology; D013124:Spinal Injuries / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000473:pathology; D013352:Subcutaneous Emphysema / Q000473:pathology; D040521:Subcutaneous Tissue / Q000473:pathology; D014132:Trachea / Q000293:injuries / Q000473:pathology