The discrepant severity of external and internal injuries in a traffic accident: The cushioning effect via a human body against direct impact: Autopsy cases

• Published in: The American journal of forensic medicine and pathology Vol. 30; no. 2; p. 186
• Main Authors: Nishitani, Yoko, Okazaki, Shunichiro, Suzuki, Kengo, Imabayashi, Kiyomi, Katada, Ryuichi, Matsumoto, Hiroshi
• Format: Journal Article
• Language: English
• Published: United States 01.06.2009
• Subjects: Accidents, Traffic; Carotid Artery Injuries - pathology; Cervical Vertebrae - injuries; Cervical Vertebrae - pathology; Female; Forensic Pathology; Fractures, Bone - pathology; Hemorrhage - pathology; Humans; Joint Dislocations - pathology; Liver - injuries; Liver - pathology; Lumbar Vertebrae - injuries; Lumbar Vertebrae - pathology; Male; Medulla Oblongata - injuries; Medulla Oblongata - pathology; Middle Aged; Muscle, Skeletal - pathology; Pons - injuries; Pons - pathology; Spinal Injuries - pathology; Subarachnoid Hemorrhage - pathology; Subcutaneous Emphysema - pathology; Subcutaneous Tissue - pathology; Trachea - injuries; Trachea - pathology
• ISSN: 1533-404X
• DOI: 10.1097/PAF.0b013e3181879ceb

Traffic accidents cause unexpectedly severe injuries of internal organs despite tiny injuries observed on the external body. A 51-year-old woman (subject 1) and a 54-year-old man (subject 2) were found dead on a road. Subject 1 had subcutaneous and intramuscular bleeding with décollement on the posterior aspect of her body, including upper cervical spine dislocation. Subject 2 did not exhibit any apparent findings on autopsy that were indicative of a direct injury by a motor vehicle, but had severe internal organ injuries, including the transection at the pontomedullary junction. We surmise that subjects 1 and 2 were walking in line with the vehicle which collided with them from behind, and then the body of subject 1 cushioned the direct impact of the vehicle against subject 2. This report illustrates the need of forensic autopsy for victims with no severe external injuries.