Traumatic hemorrhage of the thyroid gland resulting from blunt injury to the neck is a very rare event. Particular neck positions can expose the thyroid to trauma, especially in motor vehicle collisions, falls, direct blows, or sport activities. Preexisting conditions such as goiters, adenomas, and cysts can increase the risk of bleeding, reducing the force required to rupture the gland and make the thyroid more prone to injury. The authors report the case of a 53-year-old man who was involved in a fire while working on maintenance of a liquid petroleum gas (LPG)-powered car. He subsequently presented to the emergency department with painful swelling of his right anterior neck with a palpable mass. CT scan showed a right thyroid hemorrhagic cyst. The worker reported that he had jumped into the car trunk to extinguish the fire and covered the gas tank nozzle with his own body to prevent dispersal of the accelerant. In this case, the medico-legal evaluation was useful to delineate between natural and traumatic causes of the injury. Medico-legal assessment is key in understanding the dynamics involved in work-related events to identify any legal responsibilities of the worker or the employer.

The frequency and distribution of fractures are commonly utilized to assist in interpreting the manner of death. In cases of alleged suicide by hanging, however, the evidence base for the frequency and patterning of laryngohyoid and cervical vertebrae fractures resulting from such blunt force traumatic events is limited and so fractures cannot be reliably used to assist in interpreting the manner. Using meta-analytic techniques, this study aimed to estimate frequency and distribution of fractures in the context of relevant intrinsic and extrinsic variables. A systematic review of the literature identified 20 studies with relevant data (8523 cases of suicide by hanging). Meta-analyses identified the frequency and distribution of fractures present and how fracture frequency was affected by the subgroups of age, sex, completeness of suspension, ligature knot position and study design. Results indicated that fracture frequency was variable, there was no unique patterning, and high levels of heterogeneity were present in all variable sub-groups. Age was the only subgroup to show differences. Findings suggest that neck fracture frequency is inconsistent and cannot be predicted by the chosen variables. Subsequently, neck fractures in isolation should not be given weight in medico-legal interpretations of a hanging death as suicidal.

This paper presents a retrospective review of patterns found in cases of homicides by sharp force over a 13-year period at the Department of Forensic Pathology of the Ostrava University Hospital, Czech Republic. The review summarizes all frequently discussed aspects of such cases including the number and localization of injuries, the presence of defensive wounds, the type of the offending weapon, the cause of death, the place of death, victims\' and perpetrators\' profiles, their relationship, or toxicological findings. Furthermore, special attention was paid to the evaluation of any accompanying blunt force trauma that may be indicative of an escalation of the assault. The set of data was statistically analyzed. Even though most of the results of this review are consistent with available published studies, noteworthy differences have emerged in some aspects such as the sex and age of the victims, the relationship between the number of injuries suffered and the victims\' sex, or the severity of alcohol intoxication in victims.

Chylothorax is a potentially devastating complication of lymphatic trauma of the thorax. To date, no recommendations have provided decision making support for prompt definitive treatment. We present a 53 year old male involved in a motor vehicle collision sustaining 9 left rib fractures with flail segments. He was treated non-operatively with a chest tube and no fat diet. A Case report review was performed and a proposed guideline for managing blunt trauma chylothorax in adult patients was developed. In low-output chylothorax, effective initial treatment begins with a no fat diet and chest tube. We propose that a low output leak be defined as <500 mL of initial output or <500 mL/day and can be managed non-operatively in nearly 100% of patients. High output injuries of >1000 mL of initial output will require surgical intervention and should be considered for prompt definitive care.

To investigate what is currently known about skeletal blunt force trauma (BFT) resulting from falls, and how valuable that research is in contributing to forensic anthropology investigations and interpretations of circumstances of death, a comprehensive review of forensic anthropology, forensic pathology and clinical medicine literature was performed. Forensic anthropology literature identified that establishing the type of fall from the analysis of BFT is difficult given the uniqueness of each fall event, the complexities involved with identify BFT and, in particular, the limited available research documenting fracture patterning and morphologies. Comparatively, skeletal BFT resulting from fatal falls is well documented in the forensic pathology and clinical medicine literature. These disciplines cover a wide range of fall types (free falls, falls in juveniles, specific fractures produced from falls, falls down staircases, falls resulting in impalements, and \'other\' fall types), provide details on how the nature of the fall influences the skeletal fracturing, and documents the anatomical regions susceptible to fracturing. Whilst these contributions may assist forensic anthropologists, they provide limited details of fracture patterns and morphologies and thus further research investigating the details of skeletal BFT resulting from fatal falls is required.

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