Importance of an organized trauma system – Case reports

Two cases are discussed, with point in view that, many times, external injuries found on clinical examination of the body may not indicate the internal damage. Hence, an organized trauma system with particular regard to initial assessment and investigation is essential to save the life. The cases are as follows:

A dead body of a female aged about 12 years brought for medico legal autopsy from a hospital with the history of fall on steps while holding an empty water container. Clinical records reveal that there was tenderness over lower part of anterior chest wall, without any other specific findings or signs of shock. Patient died suddenly. On post mortem examination there was no evidence of external injury. On internal examination, there was rupture of liver without any damage to visceral peritoneum and abdominal and chest wall.

A dead body of a male aged about 22 years brought for medico legal autopsy with the history of being kicked by a horse. On clinical examination, damage to the chest was expected. However, there was no evidence of any injury on radiological examination. Patient died while posting for further investigation. On autopsy, a ‘V’ shaped abrasion was present in the region of left chest. On internal examination, Subdural Haematoma, Subarrachnoid Hemorrhage, and contusion to left frontal, left temporal, right parietal, and right temporal lobe was present. No damage to chest or internal organs of chest was found.