Browsing by Author "Radnić, Bojana (55245986600)"

We present a case of transmesenteric hernia resulting in the death of a 3-month-old female infant, the seventh such autopsy case reported so far. A three-month-old female infant, who initially presented with two episodes of vomiting, cramps, and constipation, was admitted to the hospital. She received symptomatic therapy and was released home. Immediately after she had been put to bed at home, she stopped breathing. There was no record of previous illnesses in the infant's medical history. At autopsy, a necrotic segment of ileum and jejunum, length about 50 cm, was found herniated through an oval defect in the mesentery and multiply strangulated. The shock caused by small intestinal obstruction with consequent intestinal necrosis due to strangulation of the small intestine through a congenital mesenteric defect was considered to be the cause of death. In clinical practice, cases of transmesenteric hernias are uncommon, especially in the population of infants and toddlers; however, these can potentially be the cause of serious intestinal obstruction, with a high mortality rate in cases left untreated. Despite the low incidence of this condition, we believe that the clinicians should keep this diagnosis in mind as a potential cause of acute abdomen and pay special attention to revealing the cause of presented symptoms. © 2024 Elsevier B.V.

We present a case of transmesenteric hernia resulting in the death of a 3-month-old female infant, the seventh such autopsy case reported so far. A three-month-old female infant, who initially presented with two episodes of vomiting, cramps, and constipation, was admitted to the hospital. She received symptomatic therapy and was released home. Immediately after she had been put to bed at home, she stopped breathing. There was no record of previous illnesses in the infant's medical history. At autopsy, a necrotic segment of ileum and jejunum, length about 50 cm, was found herniated through an oval defect in the mesentery and multiply strangulated. The shock caused by small intestinal obstruction with consequent intestinal necrosis due to strangulation of the small intestine through a congenital mesenteric defect was considered to be the cause of death. In clinical practice, cases of transmesenteric hernias are uncommon, especially in the population of infants and toddlers; however, these can potentially be the cause of serious intestinal obstruction, with a high mortality rate in cases left untreated. Despite the low incidence of this condition, we believe that the clinicians should keep this diagnosis in mind as a potential cause of acute abdomen and pay special attention to revealing the cause of presented symptoms. © 2024 Elsevier B.V.

In Europe, the first case of coronavirus disease (COVID-19) and the first COVID-19-related death were reported in France on January 24th and February 15th, 2020, respectively. Officially, the first case of COVID-19 infection in the Republic of Serbia was registered on March 6th. Herein, we presented the first case of retrospective detection of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the post-mortem-obtained vitreous humor (VH), which took place on February 5th, 2020. This is the first death in Europe proven to be caused by COVID-19 by means of post-mortem histopathological and molecular analyses. Based on this finding, it appears that SARS-CoV-2 has been spreading faster and started spreading much earlier than it had been considered and that COVID-19 was probably the cause of the much-reported pneumonia of unknown origin in January and February 2020. © Copyright © 2021 Bogdanović, Skadrić, Atanasijević, Stojković, Popović, Savić, Mihailović, Radnić, Aćimović, Damjanjuk, Despotović and Barać.

Background/Aim. Suicide and homicide are crucial social problems, especially frequent among the population younger than 40 years. The aim of this study was to assess the influence of different sociodemographic factors and relevant psychoactive substances on the difference between homicide and suicide victims. Methods. A cross-sectional study analyzed autopsy reports of 714 suicide and 166 homicide cases autopsied in five years (2011–2016). Out of these, 666 suicide and 127 homicide cases met the inclusion criteria for this study. Blood-ethanol concentration was determined by headspace gas chromatography with flame ionization detection. Analysis of substances other than ethanol was accomplished by gas chromatography-mass spectrometry and liquid chromatography with tandem mass spectrometry. Results. There was a significant difference in age, level of education, and employment rate between suicide and homicide cases (p < 0.05). The distribution of suicide and homicide cases differed significantly on weekdays compared to weekends [odds ratio(OR) = 1.5; 95 % confidence interval (CI) = 1–2.3; p < 0.05]. The presence of a psychoactive substance remained a nonsignificant predictor of whether a person would become a homicide or suicide victim (p > 0.05). Homicide victims were more likely to have significantly higher blood alcohol concentration (0.2–0.3 g/dL) than suicide victims (OR = 2.2; 95 % CI = 1–5; p < 0.05). Conclusion. The age, level of education, employment status, and high blood alcohol concentration (0.2–0.3 g/dL) of the victim were significantly different between suicide and homicide cases. © 2023 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

We present a case of 19-year-old female patient, who was injured in childhood and subsequently developed hydrocephalus, chronic elevation of intracranial pressure (ICP), and a copper-beaten skull appearance. Chronic hydrocephalus leads to an increase in intraventricular pressure, causing ventricular expansion and dislocation of adjacent cerebral structures. According to literature data, it has been hypothesized that chronically elevated ICP in persons with craniosynostosis, and other developmental structural abnormalities of the skull, may induce bone remodeling. In cases with copper-beaten skull appearance, increased ICP should be considered as a cause of death (after exclusion of all other obvious causes), and for that reason, careful examination of the skull appearance is suggested. This finding could be useful in cases with advanced postmortem changes, where it might indicate some medical conditions of the deceased or could even be considered unique feature for body identification, although this rationale should be used with great caution. © Wolters Kluwer Health, Inc. All rights reserved.

Borderline Personality Disorder (BPD) is a mental health condition marked by intense emotions, unstable relationships, and a distorted self-image, which often leads to impulsive and self-destructive behaviors. Individuals with BPD frequently engage in deliberate foreign body ingestion (DFBI), a behavior that can result in severe outcomes if dangerous objects are ingested. Herein, we present a case of 45-year-old man with a history of BPD that was found in his apartment with fatal head injuries caused by the explosion of a firecracker in his mouth. Besides extensive head injuries that undoubtedly led to lethal outcome, autopsy revealed a sewing needle deeply embedded in a cardiac muscle, with fibrinous deposits suggesting that its ingestion occurred prior to the fatal incident. Such cases are crucial because they highlight the forensic significance of autopsy findings. By integrating autopsy findings with clinical data and other relevant case circumstances, valuable information can be obtained regarding the cause and manner of death. This case underscores the importance of thorough forensic investigation in cases of unusual self-harm to accurately determine intent and underlying factors. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.

Introduction. Even though lipomas are the most common benign tumors, they are rarely found in the pericardial cavity. Although histopathologically benign, they can cause life-threatening complications by rapid growth and may therefore be clinically considered malignant. Case report. We present an 80-year-old female who was injured during a syncopal episode when falling from a standing height and suffered bodily injuries for which she was hospitalized. In the further course of her short-term hospital treatment, death occurred, and the cause of death was marked as “unknown”. At the autopsy, a dilated and tense pericardium filling up a large part of the chest cavity was noted. A well-encapsulated soft tissue mass, 20 × 18 × 3 cm in size, weighing 820 g, was visualized in the pericardial cavity. Histopathological examination revealed that the mass was a lipoma and showed acute myocardial necrosis; therefore, it was assumed that the cause of death was probably due to the compression of lipoma on coronary arteries. Conclusion. Even though intrapericardial lipomas are benign tumors, they can cause life-threatening complications and sudden cardiac death. There are numerous diagnostic methods capable of detecting intrapericardial lipomas, and with timely treatment, the patient can be cured. © 2023 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

The article describes a case of gunshot suicide to the head in a 51-year-old man. The entrance wound was located in the left temple and exit wound in the right temple. The entrance wound had the characteristics of a hard-contact gunshot wound. The most interesting finding in this case was cherry-red discoloration of the right temporal muscle surrounding the exit wound. This finding could make the determination of the entrance versus exit gunshot wound challenging, especially if the wounds are of atypical appearance. In addition, the finding described in the presented case could be the proof that carbon monoxide may follow the missile through the body and may be prominent in the soft tissue at the exit. © 2019 Wolters Kluwer Health, Inc. All rights reserved.

We believe that forensic medicine should play a significant role in the COVID-19 pandemic. Forensic pathologists should ask and answer various questions through autopsy cases during the COVID-19 period, thus providing a significant contribution to science. Some of the potential roles of forensic medicine in this issue include: determining the exact cause of death among the deceased who were SARS-CoV-2 positive, contribution to the accuracy of mortality statistics, understanding pathological mechanisms of COVID-19, tracking the presence of the virus over time, survival of the virus after death as well as dealing with medicolegal issues. A detailed multidisciplinary analysis of autopsy samples would undoubtedly help understand this new illness and its clinical management. Therefore, autopsies during the COVID-19 pandemic should not be an exception, but certainly a rule. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

This case represents a planned complex suicide in which the victim combined gunshot to the head and hanging. The most interesting finding in the presented case was pale face, but without any visible injury to it at the time the body was found (more than 24 hours after death), whereas at autopsy (20 hours later), black eyes were prominent. The removal of the ligature led to the decompression of the neck and its blood vessels with consequential blood redistribution, which, alongside the liquid state of blood, resulted in the aforementioned finding. Considering the described postponed appearance of periorbital ecchymosis, this kind of finding suggests that great caution is necessary when interpreting hematomas in terms of their vitality. © 2019 Wolters Kluwer Health, Inc. All rights reserved.

It is possible that sexually driven homicides are the consequence of sexual deviation, but more often than not the main cause of such homicides stems from a non-paraphilic person's emotional component. It is known that homicides which involve multiple stabbing are very often the result of the assailant's highly expressed affect. This study tries to establish whether such homicides are essentially related to the sexual motives of the murderer. This paper is conducted through a retrospective autopsy study that includes 766 cases of homicides. These were reviewed and analysed according to the motive of the homicide, as well as by method, age, and gender of the victim, and the relationship between the victim and the assailant. The motives of homicides are classified as non-sexual and sexual, including homicides related to rape, jealousy, amorous affairs outside of an established relationship, deviant sexual behaviour of psychiatric patients, paraphilia, and disturbed emotional relationships between the victim and the assailant. Cases include both hetero- and homosexual relationships. Multiple stabbing occurs significantly more frequently in sex-related homicides (≥3 stab wounds) than in other homicide types. When the criteria for multiple stabbing are changed (≥4, 5, or 25 stab wounds), the percentage of sex-related homicides rises in every group in relation to the increased number of wounds. Sensitivity and specificity are represented by ROC curves for 3, 5 and 7 stab wounds. The correlation coefficients between multiple stabbing and sex-related homicides regarding gender are all near 0.9. For female victims, all homicides committed by 25 and more stab wounds were found to be sex-related. Statistically, jealousy was the most frequent motive for sex-related multiple stabbing homicides. Regardless of age, homicides involving multiple stabbings should be considered sex-related, especially when the victim is female. © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

It is possible that sexually driven homicides are the consequence of sexual deviation, but more often than not the main cause of such homicides stems from a non-paraphilic person's emotional component. It is known that homicides which involve multiple stabbing are very often the result of the assailant's highly expressed affect. This study tries to establish whether such homicides are essentially related to the sexual motives of the murderer. This paper is conducted through a retrospective autopsy study that includes 766 cases of homicides. These were reviewed and analysed according to the motive of the homicide, as well as by method, age, and gender of the victim, and the relationship between the victim and the assailant. The motives of homicides are classified as non-sexual and sexual, including homicides related to rape, jealousy, amorous affairs outside of an established relationship, deviant sexual behaviour of psychiatric patients, paraphilia, and disturbed emotional relationships between the victim and the assailant. Cases include both hetero- and homosexual relationships. Multiple stabbing occurs significantly more frequently in sex-related homicides (≥3 stab wounds) than in other homicide types. When the criteria for multiple stabbing are changed (≥4, 5, or 25 stab wounds), the percentage of sex-related homicides rises in every group in relation to the increased number of wounds. Sensitivity and specificity are represented by ROC curves for 3, 5 and 7 stab wounds. The correlation coefficients between multiple stabbing and sex-related homicides regarding gender are all near 0.9. For female victims, all homicides committed by 25 and more stab wounds were found to be sex-related. Statistically, jealousy was the most frequent motive for sex-related multiple stabbing homicides. Regardless of age, homicides involving multiple stabbings should be considered sex-related, especially when the victim is female. © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Introduction Without a comprehensive postmortem investigation it is impossible to determine the cause of death among the SARS-CoV-2-suspected and-positive patients. We present two cases to discuss the postmortem detectability of SARS-CoV-2 virus and RNA stability in biological samples. Outline of cases Case No. 1: a 40-year-old man on whom the autopsy was performed four days after death. The body was stored at 4°C. Bilateral pneumonia was confirmed grossly and histopathologicaly. Molecular testing was positive for IgM antibodies, but negative for SARS-CoV-2 RNA. Case No. 2: a 28-year-old profes-sional basketball player who suffered from SARS-CoV-2 about a month earlier. The autopsy was performed two days after death. The body was stored at 15°C. Gross autopsy findings revealed advanced putrefactive changes and an enlarged heart, with visible fibrotic focuses. The histopathological finding corresponded to the sudden cardiovascular death due to the cardiac dysrhythmia most probably formed in one of the fibrotic focuses. Tests for SARS-CoV-2 RNA and antibodies (IgM, IgG) were positive in the analyzed samples. Conclusion This report suggests that SARS-CoV-2 virus can be isolated in the biological samples even after a long post-mortem prolongation of molecular analyses. We emphasize the necessity of wider studies that will define the infectiveness and biological stability of the virus in postmortem tissues. © 2023, Serbia Medical Society. All rights reserved.

It is well known that the quality of death certificates determines the accuracy of public health mortality data. In the light of a pandemic, forensic pathologists must understand the true definition of a COVID-19 death and the requirements for filling out the death certificate, as these are critical for maintaining accurate and trustworthy mortality data. To determine the scope and evolution of the COVID-19 epidemic, accurate death certification is critical. We believe that COVID-19 should be enlisted under part II or section “note” (if it exists in DC form in a particular country) of the DC in all suicide instances and putrefied bodies with positive autopsy swabs for SARS-CoV-2. In addition to our suggestions for the completion of the DC in some COVID-19 instances, we feel that forensic pathologists should follow the WHO criteria for proper DC completion in COVID-19 cases. Better physician education at this stage of the pandemic would increase adherence to existing (WHO and CDC) standards. As a result, forensic pathologists with competence in death certification could help by teaching treating physicians in this area. © 2022 Bogdanović et al.

It is well known that the quality of death certificates determines the accuracy of public health mortality data. In the light of a pandemic, forensic pathologists must understand the true definition of a COVID-19 death and the requirements for filling out the death certificate, as these are critical for maintaining accurate and trustworthy mortality data. To determine the scope and evolution of the COVID-19 epidemic, accurate death certification is critical. We believe that COVID-19 should be enlisted under part II or section “note” (if it exists in DC form in a particular country) of the DC in all suicide instances and putrefied bodies with positive autopsy swabs for SARS-CoV-2. In addition to our suggestions for the completion of the DC in some COVID-19 instances, we feel that forensic pathologists should follow the WHO criteria for proper DC completion in COVID-19 cases. Better physician education at this stage of the pandemic would increase adherence to existing (WHO and CDC) standards. As a result, forensic pathologists with competence in death certification could help by teaching treating physicians in this area. © 2022 Bogdanović et al.

Calcium, as one of the main extracellular ions, maintains a key role in numerous biologic functions. For forensic purposes, it was analyzed mostly for estimation of postmortem interval (PMI). We have designed our experiment with the concept that the repetitive withdrawal of vitreous humor (VH) might clarify the postmortem metabolism of calcium in greater detail to estimate the PMI. Accordingly, 248 samples of VH from 31 autopsy cases were evaluated over three years; samples (0,1 mL of VH) were taken and analyzed at equal time intervals after death—every three hours until 24 h after death. Each sample was centrifuged and analyzed using the ARCHITECT C SYSTEM 8000. Moreover, functional relationship between PMI and calcium concentration was established: PMI (hours) = [Ca2+] × 13.696–7.843. Although the concentration of calcium in VH in the analyzed group increases with time, the coefficient of variation for the regression (CVreg = 46.8%) indicates that this correlation is not so strong, meaning that the level of predictiveness of calcium for estimation of time since death is poor when is not used in combination with other relevant substances. © 2020 Elsevier B.V.

Calcium, as one of the main extracellular ions, maintains a key role in numerous biologic functions. For forensic purposes, it was analyzed mostly for estimation of postmortem interval (PMI). We have designed our experiment with the concept that the repetitive withdrawal of vitreous humor (VH) might clarify the postmortem metabolism of calcium in greater detail to estimate the PMI. Accordingly, 248 samples of VH from 31 autopsy cases were evaluated over three years; samples (0,1 mL of VH) were taken and analyzed at equal time intervals after death—every three hours until 24 h after death. Each sample was centrifuged and analyzed using the ARCHITECT C SYSTEM 8000. Moreover, functional relationship between PMI and calcium concentration was established: PMI (hours) = [Ca2+] × 13.696–7.843. Although the concentration of calcium in VH in the analyzed group increases with time, the coefficient of variation for the regression (CVreg = 46.8%) indicates that this correlation is not so strong, meaning that the level of predictiveness of calcium for estimation of time since death is poor when is not used in combination with other relevant substances. © 2020 Elsevier B.V.

This case represents a planned complex suicide in which the victim shot himself in the head after dousing his living quarters with gasoline. The spark induced ignition of gasoline vapors and led to an explosion. Liquid gasoline is not flammable, but the vapor/mixture of gases above the surface of the liquid is. In this case the victim might have counted on the resulting fire and/or explosion, but we are not able to tell that with certainty. We have assumed that the plan was for the gunshot to the head to lead to instantaneous death, and for the flame and/or explosion to lead to the destruction of the body. The explosion launched the body out of the apartment, meaning it did not get charred. It is also our assumption that the victim did not expect that the explosion would eject his body from the flames and lead to less severe burns than he had calculated, making this complex suicide “less successful” than he had planned. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

One of the most important tasks in forensic medicine is differentiating between a homicide and a suicide, especially in cases where more than one self-inflicted gunshot wound is present. The significance is even greater when the victim’s ability to act after the first gunshot is questionable. In these cases, the only way to determine the sequence of the shots is to consider the severity of the injuries and their disabling effect. Therefore, the importance of previously mentioned facts is even greater, not only in everyday forensic practice but also in court. The questions dealing with the crime scene and interpretation of the wounds’ trajectories are of the utmost importance. © The Author(s) 2019.

One of the most important tasks in forensic medicine is differentiating between a homicide and a suicide, especially in cases where more than one self-inflicted gunshot wound is present. The significance is even greater when the victim’s ability to act after the first gunshot is questionable. In these cases, the only way to determine the sequence of the shots is to consider the severity of the injuries and their disabling effect. Therefore, the importance of previously mentioned facts is even greater, not only in everyday forensic practice but also in court. The questions dealing with the crime scene and interpretation of the wounds’ trajectories are of the utmost importance. © The Author(s) 2019.