Stephan A Bolliger1, Thomas D Ruder2, Thomas Ketterer3, Nadine Gläser4, Michael J Thali5, Garyfalia Ampanozi5. 1. Institute of Forensic Medicine, Department of Forensic Medicine, Cantonal Hospital, Aarau, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Bern, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Switzerland. Electronic address: stephan.bolliger@irm.uzh.ch. 2. Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Bern, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Switzerland; Institute of Diagnostic, Interventional, and Paediatric Radiology, University Hospital Bern, Switzerland. 3. Institute of Forensic Medicine, Department of Forensic Medicine, Cantonal Hospital, Aarau, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Bern, Switzerland. 4. Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Bern, Switzerland. 5. Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Bern, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Switzerland.
Abstract
BACKGROUND: Instillation of contrast medium into stab wounds has shown promising results regarding visibility and assessment of general stab direction with computed tomography. However, the accuracy of this method--and, incidentally also probing of stab wounds--has to our knowledge not previously been examined. Also the effect of bluntness of different stabbing objects on the examination of stab wounds was not considered before this study. METHODS: Using a pocket-knife, a steak-knife, and a Phillips screwdriver, nine stab wounds each were inflicted to three pork haunches. The depths of the stab wounds were determined by probing and multislice computed tomography (MSCT) after instillation of a contrast medium (CM) and then compared to those observed by dissection, our internal "gold standard". RESULTS: In stab wounds inflicted by knives, MSCT-CM and probing provided results which differed by roughly 10-11% from the dissection results. In screwdriver stabs MSCT-CM showed a deviation of almost 30%, probing over 33%. DISCUSSION: MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate. CONCLUSION: MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate.
BACKGROUND: Instillation of contrast medium into stab wounds has shown promising results regarding visibility and assessment of general stab direction with computed tomography. However, the accuracy of this method--and, incidentally also probing of stab wounds--has to our knowledge not previously been examined. Also the effect of bluntness of different stabbing objects on the examination of stab wounds was not considered before this study. METHODS: Using a pocket-knife, a steak-knife, and a Phillips screwdriver, nine stab wounds each were inflicted to three pork haunches. The depths of the stab wounds were determined by probing and multislice computed tomography (MSCT) after instillation of a contrast medium (CM) and then compared to those observed by dissection, our internal "gold standard". RESULTS: In stab wounds inflicted by knives, MSCT-CM and probing provided results which differed by roughly 10-11% from the dissection results. In screwdriver stabs MSCT-CM showed a deviation of almost 30%, probing over 33%. DISCUSSION: MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate. CONCLUSION: MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate.