Forensic, clinical and anatomical aspects of diagnosising diaphragmatic injuries in stab wounds

Abstract

To improve the quality of clinical and forensic examination and diagnosis of diaphragmatic injury (DI) from stab wounds by defining the boundaries of the thoraco-abdominal region and the topographic and anatomical characteristics of thoracoabdominal stab wounds. Based on the results of forensic medical examinations of 81 corpses with stab wounds, the clinical and anatomical characteristics of thoraco-abdominal stab wounds were noted; and in anatomical dissections of 90 cadavers, the boundaries of the intercostal spaces and costophrenic recess were modeled. The boundaries of the thoraco-abdominal region, and the location of stab wounds that make the probability of DI particularly high (10-50%) were clarified. A method for diagnosing DI was developed. The method was used to identify DI in 81 out of 411 victims with penetrating stab wounds to the chest and abdomen. The results of the study prove the feasibility of using computed tomography in the examination of living persons with a wound in the thoracoabdominal region. This study can assist in determining the features of a wound channel, in providing a correct assessment of the damage, and in the identification of undiagnosed DI.