title: Forensic Features of Lethal Late-Presenting Diaphragmatic Hernias.
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.
authors.affiliation: Anatomical Pathology, SA Pathology, Frome Rd, Adelaide, SA 5000, Australia.|Forensic Science SA, 21 Divett Place, Adelaide, SA 5000, Australia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Thompson
authors.affiliation: Forensic Science SA, 21 Divett Place, Adelaide, SA 5000, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wills
authors.affiliation: Forensic Science SA, 21 Divett Place, Adelaide, SA 5000, Australia. roger.byard@sa.gov.au.|School of Medicine, The University of Adelaide, Frome Rd, Adelaide, SA 5005, Australia. roger.byard@sa.gov.au.
authors.forename: Roger W
authors.initials: RW
authors.lastname: Byard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D003643:Death; D005260:Female; D044707:Forensic Sciences; D006548:Hernia, Diaphragmatic; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D013270:Stomach
keywords: death; diaphragm; forensic science; hernia; lung compression; perforation