Аспирационная асфиксия дыхательных путей кровью и желудочным содержимым при травмах и заболеваниях. Клинический случай и литературная справка

This article is devoted to aspiration airway asphyxia with blood and gastric contents, which often complicates the course of various diseases, pathological conditions and injuries. The article presents a fatal case from the practice of post-mortem diagnosis of this type of asphyxia in a patient with oncological disease. The authors for the first time draw attention to the need to introduce this nosological form into the heading block W75-W85 of class XX - ICD.Данная статья посвящена аспирационной асфиксии дыхательных путей кровью и желудочным содержимым, которая нередко осложняет течение различных заболеваний, патологических состояний и травм. В статье приведен летальный случай из практики посмертной диагностики от данного вида асфиксии, развившегося у пациента на фоне имевшегося у него онкологического заболевания. Авторы статьи впервые обращают внимание на необходимость ввода этой нозологической формы в блок рубрик W75-W85 класса ХХ - МКБ

Morphological characteristics of different rates of dying

The purpose of the study: scientific evidence and development of accessible morphological criteria that allow to determine the duration of dying and the rate of dying. Materials and methods. The material of the main study included 206 identified deaths of persons with different pre-known processes of dying, which served as criterion for selection from1500 deaths (n=206, 14%). Of these, 110 cases were observed by the forensic medical expertize, 79 cases were revealed by the forensic medical examination of the dead body and 17 cases were included after the postmortem autopsy. The sample included from 30 to 57 cases subdivided in 5 groups. 53 cases were selected for the first time interval, 30 observations for the second one, 32 observations for the third one, 34 observations for the fourth one and 57 observations for the fifth time interval. The following methods were used to study the material: analysis of information about the circumstances of death (based on the records), retrospective clinical and anatomical analysis, the main (classical) method of autopsy of human corpses in sectional studies and histological examination. In addition, an immunohistochemical test, as well as mor-phometric, macroscopic and photographic methods were used. For the accuracy and reliability of the findings, morphological and statistical analysis was used, which included both statistical analysis of morphological characteristics and tanatogenetic analysis of the cases of the sampled material. Study results. We developed and scientifically proved a methodology for determining 5 rates of dying according to the morphological characteristics systematized in morphological complexes: fulminant rate 30 min — 2 — 6 — 12 h. Approbation of the proposed method on the gross experimental material allowed to set the diagnostic limit of the total significance for each morphological complex, and thereby, to improve the methodology of establishing the rate of dying in accordance to the morphological characteristics for the use in forensic practice. Conclusion. The morphological complexes of the rate of dying established in this work would serve as a base for further development of not only forensic thanatology, but also for the aim of improving the medical and preventive care. © 2018, V.A. Negovsky Research Institute of General Reanimatology. All rights reserved