INJURIES ON ABDOMEN

INJURIES ON ABDOMEN

Injuries on the abdomen may similarly be caused by blunt weapon or sharp cutting or sharp cutting and pointed weapon or projectile of a firearm weapon.

Blunt force, when applied over the abdomen may cause only external wound, only internal wound or both. Due to the soft and yielding nature of the abdominal wall, application of even a heavy force may not cause any external wound on the abdominal wall but the transmitted force may cause serious internal wound. This occasionally may leave an external abrasion only. But internally there may be extensive haematoma with contusion, laceration or even gross rupture of the organs like, liver, spleen or kidneys with or without injuries to the intestines, stomach, urinary bladder or very occasionally the gall bladder, ureters and ovaries. Enlarged spleen, liver, gravid uterus and full urinary bladder are more vulnerable to blunt force injuries than the normal organs. Laceration or rupture of intra-abdominal organ or organs may cause extensive intra-abdominal haemorrhage. If the person survives for a few days with injury to the intra-abdominal organs, then ultimately peritonitis may develop.

INJURIES ON ABDOMENIn case of being run over by a vehicle over the abdomen there may be rupture of the abdominal wall with exposure of the intestine and other abdominal organs.

Self-inflicted incised wounds may be present over the anterior abdominal wall, where they are multiple, parallel to each other, grouped together, superficial and mostly transverse across the midline.

Incised wound on the unapproachable parts of the body, if not very superficial and grouped together (as are fabricated wounds, produced with the help of an accomplice), are mostly homicidal and occasionally accidental. When homicidal incised wounds are caused by way of drawing the sharp edge on the skin, then the tailing produced will tell about the position of the assailant in relation to the position of the victim. When reasonably deep incised wounds are multiple and scattered over different parts of the body, including the self-un-approachable parts of the body, then they cannot be anything but homicidal in nature. As in case of accidental incised wounds over the thorax, accidental incised wounds over the abdomen is also possible, but this is not usually more than one in number and are not scattered over different parts of the abdomen.

Chop wounds are also possible on the abdomen and they may even penetrate the abdominal wall to enter the abdominal cavity. However, on the abdomen, chop wounds are usually located over the flanks or on the back side.

Punctured wounds on the abdomen may be caused by pointed weapons or firearm projectiles. Punctured wounds are more commonly found in or near the flanks and front, but in some cases they may be present on the back side also. These wounds on the abdomen are mostly homicidal and only very occasionally may be suicidal or accidental.

Stab or punctured wound by a dagger, on the abdomen may create problem so far assessment of the length of the blade of the weapon and the direction of the stabbing are concerned. Confusion about the actual depth of the puncture, i.e., the length of the blade may arise when the victim is stabbed on the anterior abdominal wall. Ordinarily, if around the wound of entrance there is a hiltmark, then that is indicative that the whole length of the blade of the weapon went inside. If in such a case there is no exit wound on the opposite side, then it is further indicative that the depth of the wound in such a case should give the length of the blade of the weapon. But when a stab wound is caused on the anterior abdominal wall, due to soft and yielding nature of the wall, the force of the impact will reduce the antero-posterior dimension of the abdomen at that spot and the tip of the blade will reach further posterior than its length should ordinarily allow. When the weapon is withdrawn, the anterio-posterior distance comes back to its normal and during post-mortem examination we may get a greater depth of the wound which may wrongly give the impression that the length of the blade of the weapon is more (than what it actually is). In case of penetrating wounds over abdomen, its direction may also be interpreted wrongly during post mortem examination, if the perforation was caused in erect or upright position. The injured internal structures which were at a lower position during sustaining the punctured wound will obviously assume a comparatively higher level in lying position on the dissection table. This may give a false impression that, the direction of the punctured wound was upward, though in reality it was not.

Intra-abdominal injury may also be caused through the vaginal route, e.g. in case of an attempted abortion by an instrument.