THE EVALUATION OF A COMPLEX
MEDICO-LEGAL CASE WITH SYNCOPE, DIFFUSE SUBCUTANEOUS EMPHYSEMA, BILATERAL PNEUMOTHORAX AND EUSTACHIAN VALVE.
Asirdizer M, Yavuz
MS, Zeyfeoglu Y, Tatlisumak E.
Journal of Forensic Medicine (Turkish Journal),
2007, 21(3): 41-7.
One of the most important duties of a medical examiner is to define its cause
when an injury occurred. An injury may occur due to violence e.g. child abuse, accidents e.g. home accidents, attempts to
suicide e.g. jumping, or it may follow an illness. Even it may occur iatrogenically. The process of medico-legal diagnosis
is not easy every time, especially if the victim is a child. The anamnesis and the observation of the behaviors of children
and parents are very important but not always sufficient for diagnosis.
The case submitted in this report is a nine year old male child. He was hospitalized
in the State Hospital after fainted in the bathroom of his house. During the entrance of Manisa State Hospital, he was unconscious,
his arterial blood pressure was 180/110 mmHg, his arterial pulsation rate was 180/minute, his respiration was shallow and
there was a circular abrasion with 2 cm diameter on the right frontal region of his head. He was transferred to Celal Bayar
University Hospital after endotracheal intubation. Syncope, diffuse subcutaneous emphysema on his neck, thorax and abdomen
and bilateral pneumothorax was diagnosed at University Hospital. Eustachian valve was detected during echocardiography. He
was sent to Forensic Medicine Department of University Hospital for the preparation of his medico-legal report after he was
In this report, we submitted the medico-legal evaluation of a case with eustachian
valve, diffuse subcutaneous emphysema and bilateral pneumothorax and difficulties during medico-legal diagnosis as the major
cause of the clinical aspects among trauma, illness, medical malpractice or complication.
Key words: forensic medicine, medical malpractice, eustachian valve,
pneumothorax and subcutaneous emphysema.