Rare impaling injury to the neck

Abstract

Introduction: Impaling injuries are uncommon. They result mostly when rigid objects with a pointed or tapering end penetrate the body. Circumstances include falls and traffic accidents. Individuals falling or jumping from a structure onto pointed objects such as spiked fences or pointing metal rods are common scenarios. Current case is a death of a heavy alcoholic falling onto a pointed stump of a tree injuring the neck. History and scene examination A 65 year old male had left home to buy an alcoholic drink, and was found fallen in prone position the following day, in an area with a lot of bushes. The injury over the left side of the neck was in contact with a pointed blood stained stump of a tree about 45cm in height. Autopsy There was a V shaped defect of the shirt front just below the collar. The shirt was thickly stained with blood around the defect. There was a gaping elliptical shaped penetrating wound over the front of left lower neck with irregular and abraded margins. Underlying soft tissue and muscle contusion were present. There was complete transection of the internal jugular vein. The injury had penetrated into the thoracic cavity causing a 400 ml haemothorax. There were no injuries in the rest of the body. All organs were pale. Conclusion A rare case of impaling injury is reported. In similar cases where the body of the victim is discovered further away from the tree stump, foul play could be suspected. If the tree stump was missed at the crime scene this suspicion would be further strengthened with the possibility of miscarriage of justice. This case illustrates the importance of a thorough examination of the scene to detect the cause of impaling injuries. Medico-Legal Journal of Sri Lanka 2015; 3(1) : 29-32