title: Decubitus ulcers and ligature marks as evidence in a homicide case.
abstract: When abuse, maltreatment and neglect are suspected, a proper physical examination is essential. This is even more important at autopsy, when there is no possibility to gain information from the alleged victim and where the forensic pathologist has to link the evidenced signs or sequalae of abuse with the possible manner and cause of death. This case report presents the results and conclusions of the medico-legal autopsy of a 30-year-old woman found dead in her fiancé's home. The conditions and material evidence found on scene aroused doubts on the cause and manner of death. Dermatological signs found on the corpse (abrasions, contusions and decubitus ulcers) suggested a history of domestic abuse and neglect that was further confirmed by a detailed macroscopic and microscopic examination of the body. An insight into the woman's medical history further implied the possibility of long-term domestic violence. The forensic pathologist reported bronchopneumonia as the main cause of death, provoked by the combined effect of malnourishment, deliberated immobilization and neglected decubitus ulcers. This case is uncommon as it presents the homicide of a young woman caused by a prolonged abusive behaviour associated with complete neglect of her aggravating health conditions and provoked injuries.
authors.affiliation: Department of Forensic Medicine and Criminalistics, Rijeka University School of Medicine, Braće Branchetta 20, 51 000 Rijeka, Croatia.
authors.forename: Drazen
authors.initials: D
authors.lastname: Cuculic
authors.affiliation: Department of Forensic Medicine and Criminalistics, Rijeka University School of Medicine, Braće Branchetta 20, 51 000 Rijeka, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Sosa
authors.affiliation: Department of Forensic Medicine and Criminalistics, Rijeka University School of Medicine, Braće Branchetta 20, 51 000 Rijeka, Croatia. Electronic address: anja.petaros@yahoo.com.
authors.forename: Anja
authors.initials: A
authors.lastname: Petaros
mesh_terms: D000328:Adult; D001996:Bronchopneumonia / Q000473:pathology; D003288:Contusions / Q000473:pathology; D017579:Domestic Violence; D005260:Female; D049429:Forensic Pathology; D006708:Homicide; D006801:Humans; D044342:Malnutrition / Q000209:etiology; D019838:Neck Injuries / Q000473:pathology*; D003668:Pressure Ulcer / Q000473:pathology*; D012149:Restraint, Physical / Q000009:adverse effects*
keywords: Decubitus ulcers; Domestic violence; Homicide; Malnourishment; Neglect; Torture