Journal of Forensic Medicine

We report the case of a middle-aged male working on board a ship. His body was found floating in the river, near shoreline, by security officials. A postmortem on the decomposed body revealed a recent myocardial infarction. Comorbid conditions included coronary atheromatous disease and long term tobacco smoking. Not all bodies found dead in water are likely to have drowned. This case demonstrates the importance of a thorough forensic investigation, particularly in histological terms, in subjects found dead in water, in order to ascertain the real cause of death, which may not be always assigned to asphyxia by drowning.

Forensic science is the application of science and technology to the detection and investigation of crime. Forensic science has shaped the world of justice, signifying the examination of crime with the help of modern and advanced technology. In this retrospective study, the viscera sent to toxicology and DNA section of FSL during autopsy at mortuary of Adichunchanagiri Institute of Medical Sciences, Mandya district, Karnataka, India, between January 2013 to December 2017 were analyzed. During this study, several epidemiological observations and their results were considered. Out of 748 autopsied cases, in 256 cases viscera has been forwarded to Toxicology section of forensic science laboratory and in 43 unidentified bodies either femur bone or liver tissue has been forwarded to DNA section. In all the 256 cases viscera has been subjected to toxicological examination at forensic science laboratory, in that 211 cases we received positive results, stating the type and amount of poison present at the time of death. In 43 cases viscera has been forwarded to DNA section, and the report has been forwarded to honorable court. With the rising population combined with inflation and economic downturns, there is an increased spurt of crime rates of all natures in the society. To ensure adequate and timely justice to the victims of offences a proper autopsy coupled with laboratory backing will go a long way in supplementing the work of police investigation in order to convert suspicion into a reasonable certainty of either guilt or innocence.

Introdução
Morte súbita devido a causas gastrointestinais (GI) equivale a 10% de todas as mortes súbitas. Varizes esofágicas são uma das causas GI de morte súbita. Ela se desenvolve como uma complicação da cirrose hepática. A prevalência de varizes esofágicas em pacientes com cirrose é de 50% e a taxa de mortalidade varia entre 20%-35% com proporção de homens e mulheres de 1:9. A taxa de sangramento de um ano de varizes pequenas e grandes é de 5% e 15%. A taxa de mortalidade aumenta com o aumento da idade.
Série de casos
Seis casos de morte súbita foram vistos no necrotério de um hospital terciário. Os seis casos eram homens, alcoólatras. Na autópsia, foram observados achados semelhantes de fígado cirrótico e mucosa hemorrágica do estômago com pontos de sangramento no terço inferior do esôfago.
Discussão
Colaterais se desenvolvem com o desenvolvimento de hipertensão portal. Alguns locais são predispostos a se romper, como as varizes esofágicas. Os fatores de risco de ruptura varicosa são estrias vermelhas no lúmen do esôfago e testes de função hepática alterados. No exame macroscópico, são observados sinais de funções hepáticas alteradas. No exame interno, o esôfago é evertido, preso ao estômago, e as varizes são vistas brilhando através da mucosa. O fígado tinha alterações cirróticas e o baço estava aumentado e congestionado em todos os seis casos.
Conclusão
A série de casos enfatiza a importância da hemorragia varicosa esofágica fatal como uma causa importante de morte súbita que ocorre fora do hospital em indivíduos dependentes de álcool, frequentemente em cenários isolados.