Determination of the pressure of damage to the spleen histological method in mechanical injury in forensic medical practice

Abstract

Introduction. The trauma of the spleen in the minds of the minds should be accomplished often by that middle of the body of the empty light of a loan from one of the other countries. The frequency of spleens injuries according to the literature ranges from 15 to 33%. Also, it is often necessary to postpone a long time about the injuries of the spleen. One of the methods used in the long-term follow-up injuries spleens histological method. The aim of this work was to study the dynamic changes of histological parameters injured spleens tissues in various types of mechanical injury, depending on the period of injury. Material and methods. The material for the present study, there are tissues of the spleens 78 people male and female, aged 20 to 60 years, who died at injury of spleens and subjected to autopsy in Thanatology Department Office of Forensic medical examination. In research conducted used: histological, histochemical techniques to detect dynamic processes of regeneration histological parameters injured tissues of the spleens and performed statistical analysis of the results. Results and discussion. As a result of research we have found that the mechanical injury of spleen ruptures often developed capsule and parenchyma with the presence of hemorrhage in the area of injury. Our records show that during the first 6 hours after injury, histological examination of the spleens is damaged hematoma in a cluster of erythrocytes orange with clear contours, center pieces hematoma observed hemolysis of erythrocytes; closer to the edge of the hematoma determined by single leukocytes, fibrin strands. Note that the edge of the hematoma increases perifocal edema. In vessels were observed lekocytic stasis and perifocal accumulation of leukocytes. Within 6-12 hours after injury most damage red blood cells in the center were vague outlines, notes their common hemolysis, sometimes intact erythrocytes are just on the edge of the hematoma, the number of granulocytes in the cell increases bleeding and begin their destruction. Within 12-24 hours watched hemolyzed erythrocytes, granulocytes completely destroyed. Limit shaft is formed, represented destroyed granulocytes, macrophages with hemosiderin intracellular grains, fibrin strands on the edge of the hematoma intact tissues, blood clots in the blood vessels are. Further, for 2-3 days, beginning resorption products of destruction of red blood cells and start forming siderophage. On the edge of hematoma, on the border with intact tissue proliferation begins histio-fibroblastic cells, platelets organization in the vessels. Continuing formation demarcation shaft as fuzzy mass of fibrin strands in which grow in histio-fibroblastic cells and collagen fibers form a delicate including many hemosiderophages. With the emergence of damage limitation period 4-6 days observed prevalence of connective tissue elements (lymphocytes, histiocytes, plasma cells), there is a massive collapse of granulocytes, signs of blood clots in the vessels of the spleen. After 6 days continues capsules of hematoma formation. Hematoma presented erythrocytes are hemolyzed completely, a large number of leukocytes nuclear detritus, the integrity of which is broken, compacted fibrin strands, which clearly demarcates hematoma of damaged tissue by parenchymal hematoma to grow multiple strands of histofibroblastic cellular elements, delicate collagen fibers, which are beginning to form a capsule. Conclusions. As a result of the above, the morphological picture could differ from those explained earlier that you must consider when installing old injury. Thus, the results indicate that in the injured tissue legitimate spleen observed histological changes that are directly dependent on the time elapsed since the infliction of harm. Using histological methods to determine the time of causing harm, as in the case of isolated spleens injury, and in the case of the United trauma of the abdomen, is appropriate because it allows you to increase the objectivity of the results establish limitations causing injury. Summary. As a result of the analysis of literary sources and a statistical analysis of our own research on the nature, mechanism and prescription of spleen injury, it was possible to determine the duration of damage to the spleen in case of mechanical injury by the dynamics of changes in its histological parameters, which is important in forensic practice.