M. Hitosugi, A. Takeda, S. Hiraizumi, S. Moriguchi
Abstract: In practical forensic medicine, detecting embolisms is important for not only determining the cause of death but also suggesting vital reactions of the victim. We herein report the first autopsy case of a victim with liver tissue embolism in the portal vein. A healthy man in his 40s immediately died of chest compression by the grinder of motor vehicle parts while working. Postmortem computed tomography and forensic autopsy revealed massive destruction of the bilateral ribcage, lung injuries, and massive liver injuries. Microscopically, apart from the injured region of the liver, injured liver tissue was impacted in the portal veins. Although bone marrow embolism or fatty embolism often occurs after severe trauma, these findings are difficult to detect if the intrathoracic pressure is high or the rib cage is massively injured, as in the present case. Therefore, examining embolisms at locations other than the pulmonary arteries is worthwhile for forensic pathologists to show vital reactions. In the present case, injured liver tissues were transported via the blood flow of the portal vein. Because such embolisms appear at uninjured sites of the liver, blood flow might be observed immediately after the injury. This case suggests new findings of a vital reaction following massive chest compression and the importance of microscopic analysis of injured patients. Keywords: liver tissue embolism, portal vein, chest injury, liver injury, vital reaction.
