ABSTRACT
Explosions from the detonation of an explosive device (bomb) or another explosive substance cause a unique array of injuries. Most of the original descriptive work on the pathology of bombing and related injuries derives from professors T. K. Marshall (Marshall 1976, 1977, 1988) and J. Crane (Hull et al. 1994; Lucas and Crane 2008) in Northern Ireland and the pathology of high-energy injury in aviation accidents by Professor Mason (Mason 1965). However, there have been further developments in our knowledge of the pathology of explosive injuries in the past few years. ›ese developments relate to further examination of victims in civilian/domestic explosions and terrorist bomb events. At this point in history, more forensic pathologists have been exposed to the pathology of explosive
19.1 Introduction 741 19.2 Pathology of Explosive Injury 742
19.2.1 Explosion-Related Injuries 742 19.2.2 Body Disintegration, Fragmentation, and Mutilating Injury 743 19.2.3 Burns from Radiant Heat 745 19.2.4 Dirt and Dust Tattooing 746 19.2.5 Peppering or “Body Stippling” 746 19.2.6 Penetrating and Perforating Shrapnel Injuries 746 19.2.7 Internal Blast Injuries 748 19.2.8 Fat Embolism 749
19.3 Medicolegal Issues at Autopsy 749 19.3.1 Identi‡cation and Minimum Number of Individuals 749 19.3.2 Radiologic Examination 750 19.3.3 Collection of Physical Exhibits 750 19.3.4 Documentation of Injuries 751 19.3.5 Disease and Toxicologic Considerations 751 19.3.6 Position and Range of Explosion 751 19.3.7 Cause of Death 751
19.4 Emerging Issues in Explosive Injury 752 19.4.1 ›e Medical Frontier of Explosive Injury 752 19.4.2 Improvised Explosive Devices 753 19.4.3 Design of Protective Garments 753 19.4.4 Traumatic “Blast” Brain Injury 753
Acknowledgments 754 References 754
injuries than ever before. ›is is, in part, due to the increasing requests for postmortem examination of soldiers who are victims of bombs. ›is is secondary to a recent international movement to perform autopsies on the soldiers a—er they are repatriated to their home countries.
