Precise wound track measurement requires cat scan with object in situ: how accurate is post-mortem dissection and evaluation?

Abstract

A middle-aged man committed suicide by stabbing and cutting himself repeatedly. The case was initially treated as suspicious as he was found naked in the forest not far from his home with multiple injuries to the neck, extremities and chest and with a kitchen knife still located in the chest. The kitchen knife was inserted to the full length of the blade with only the handle visible. However, the events leading up to his discovery together with the results from the autopsy did support suicide as the manner of death. The deceased was transported to the National Board of Forensic Medicine department in Linkoping, Sweden, for examination. Computer assisted tomography (CT) was performed according to standard practice [1] with 3D volume rendering performed on the image material acquired. The position of the knife could clearly be seen on the CT images and the material from the digital autopsy also showed heart and lungs pushed over to the right side of the chest cavity. The angle and depth of the knife were measured at 45 (from the sagittal plane) and 19 cm. Angle and depth are clearly visible in the images (Fig. 1). An autopsy was performed and the injuries were documented. When the knife was removed the heart and lung regained its original position in the chest cavity thereby altering and concealing the position of the organs as seen on the CT image (Fig. 1). The depth of the new virtual wound track was estimated to 10 cm and the angle was straight in (0 from the sagittal plane) from front to back.