autopsy,
Raudha’s autopsy not consistent with Bangladesh Human Right Commission recommended standard protocol for autopsy
The Bangladesh National Human Right Commision’s Recommendation on Autopsy Protocol states that the dead body should be radiographed before it is removed from its pouch or wrappings and also X-rays should be repeated before and after undressing the body and document any skeletal system injury by X-ray.
When Raudha was found dead
at her hostel room there were marks of manual strangulation on her neck apart
form a non continuous ligature mark which did not match with the ligature found
at her room. But the forensic doctors led
by Professor Dr. Mansur Rahman who conducted Raudha’s first autopsy did not conduct the
radiological investigations of her body .They did not conduct even the most
basic X-rays of the neck AP and lateral and Chest radiograph.
The board led by Prof Mansur
Rahman of Barind Medical College includes former teacher of Rajshahi Medical
College( RMC) Prof Emdadur Rahman, who is currently working at the Islami Bank
Medical College, and Enamul Haque, a lecturer at the RMC.
When they shared the first post
mortem autopsy findings with the media I met the forensic doctors Prof Mansur
Rahman and Prof Emdadur Rahman and
Islami Bank Medical college Principal Dr. Nazrul Islam and asked them why X-ray
of the neck was done then Prof Dr.Emdadur Rahman told that it is not required.
But when they conducted the
second post mortem of Raudha they included
Dr. Hafizur Rahman, associate professor of the radiology and imaging
department of Rajshahi Medical College to conduct radiological investigations.
The first autopsy report shows the differences in what the forensic
team found and what the police of Rajsahi
Metroplotian Police found in their inquest report of Raudha.Their findings have
now become a case of debate among some senior doctors at Rajshahi Medical
College.The second autopsy report is still pending.
 |
Primary signs in a case of manual strangulation:subcutaneous and intramuscular hemorrhage.a: Contusion in the subcutaneous fatty tissue above the right mandibular angle (axial
STIR MR image, TR 2580 msec, TE 14 msec, TI 130; arrow). This type of injury is characteristic of manual strangulation and results from pressure on the mandibular angles during the assault. b: The same region at autopsy, after incision of the subcutaneous fatty tissue. The lobules of fat tissue were contusioned and hemorrhagic. c: Intramuscular hemorrhage (arrows) depicted in the left sternocleidomastoid muscle by axial T2-weighted fat-saturated MRI (TR 4000 msec, TE 90 msec). The muscle shows hyperintensities and swelling in comparison to the right side. d: Moderate intramuscular hemorrhage at autopsy (arrows). |
X-ray should be done in
nearly all strangulation victims and patients with a mechanism consistent with
hanging. It is useful to detect fractured hyoid bone and for evaluation of sub cutaneous
emphysema due to fractured larynx. Fractures of the cervical vertebrae are
extremely rare in strangulation injuries unless there has been a hanging with a
free-fall drop of the body.
 |
| Osseous injury in a case of suicidal hanging. a: MSCT showing a fracture of the left hyoid bone (small arrow). The strangulation mark appeared as a deep impression of the skin on both sides of the neck (large arrows). b: 3D reconstruction of MSCT data clearly depicting the deviation at the fracture site. c: Left hyoid bone specimen after the maceration procedure. Even after maceration of the bone, the fracture was hardly detected (arrows). d: Electron microscopic examination ( 29, 4 kV) demonstrating the fracture line through the entire diameter of the hyoid bone. |
CT scan is indicated to
detect hyoid bone and laryngeal fractures, injury to carotid arteries and other
soft-tissue abnormalities that may not be apparent on plain radiographs. CT
head is done to evaluate neurological status. CT is more sensitive for bony
injuries, subcutaneous emphysema, soft-tissue edema, and internal hemorrhage. Multi
slice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) are
appropriate options for diagnostic investigations of the neck and throat
following strangulation. MRI is the most useful imaging modality for the majority
of such victims because of its highest sensitivity for deep soft-tissue injury
including the larynx and vessels.
The benefit of such
techniques includes the ability to create a permanent record, for the purposes
of investigation and judicial usage. Doctors within all fields are also
familiar with the technique and examining the developed films through its numerous
clinical applications, although definitive reporting of the film should be
undertaken by a consultant radiologist with experience in examining
roetgenograms of adult and childhood trauma, as well as postmortem changes.
 |
| Lymph node injury following manual strangulation. a: A hyperintense lymph node was detected on the left side of the neck (large arrow) on a coronal T2-weighted fat-saturated MR image (TR 4000 msec, TE 98 msec). The left shoulder showed contusioned, hyperintense subcutaneous fatty tissue (small arrows). b: Forensic-pathological correlation at autopsy. The lymph nodes appear dark red (arrow). c: Histological specimen ( 25) demonstrating extensive hemorrhage (large arrows) in the lymph node. A layer of erythrocytes in the connective tissue surrounding the lymph node (small arrows) confirmed the traumatic genesis of the finding. |
The application of radiological
investigations in cases of medicolegal
interest originated within
months of Wilhelm Conrad Roentgen’s discovery of
X-rays (known commonly, although
incorrectly, as an “X-ray”) in 1895; a case of injury
through negligence was pursued in a British
court. Despite witness and medical testimony, the radiological
evidence proved crucial in swaying the jury as to
the extent of damage inflicted. Subsequently, the first
description of radiological evidence’s use in a murder trial was
recorded the following year when the new technology revealed the
presence of intracranial metal projectiles as
a consequence of an ultimately fatal gunshot injury.
X-ray is the most common, basic and
essential imaging method used in forensic medicine. Apart from X-ray computed tomography and magnetic resonance
imaging, are more and more applied in forensic medicine. Their application
extends possibilities of the visualization the bony structures toward a more
detailed imaging of soft tissues and internal organs. The application of modern
imaging methods in postmortem body investigation is known as digital or virtual
autopsy. At present digital postmortem imaging is considered as a bloodless alternative
to the conventional autopsy.
 | |
| Horizontal fracture of the thyroid cartilage caused by hanging. Axial (A) and coronal (B) bone window 2D MPR show fractures of the superior horns of the thyroid cartilage (arrows) without associated soft tissue emphysema. Note that in (A) only the left fracture line is seen, whereas in B, involvement of both superior horns is readily appreciated (arrows). Right lateral (C) 3D VR of cartilages and hyoid bone (yellow), and of airways (blue) show an abnormal anterior tilting and inferior displacement of the hyoid bone (dashed arrow). This abnormal position is caused by the action of the infrahyoid muscles. It strongly suggests associated injury of the suprahyoid muscles |
 |
| Primary signs in strangulation by suicidal hanging. a: Coronal STIR MR image (TR 3000 msec, TE 14 msec, TI 120) showing subcutaneous desiccation in the strangulation mark area (small arrows) and a deep impression of the skin in the lateral neck parts (larger arrows). Subcutaneous desiccation underneath the strangulation mark results from compression of the skin and subcutaneous layers due to the strangulation mechanism, and is seen as a hypointense signal in this STIR MR image. b: At autopsy, band-like subcutaneous desiccation is present in the region of the strangulation mark. |
Posts
I hope the disgusting animals that took your daughters life get exposed for their crimes, god is going to burn them in hell for taking the life of such a pure human being. I hope you find peace sir.
ReplyDelete