Chapter 1154 Cause of Death Determined
Chapter 1154 Cause of Death Determined
“The bone density of the sternum is normal,” Zhang Lin said, separating the connection between the sternum and the costal cartilage. “The degree of costal cartilage calcification is consistent with the characteristics of a 35-40 year old male. There is slight ossification in the 5th-7th costal cartilages, which is consistent with the age estimate.” After exposing the chest cavity, the condition of the lungs immediately attracted attention—they were obviously swollen, with blunt and rounded edges, dark red in color, and left indentations when pressed.
“Both lungs are swollen and heavy,” Zhang Lin said, lifting the lower lobe of the left lung with hemostats. A large amount of foamy fluid oozed from the cut surface. “This is a typical manifestation of acute pulmonary edema. The alveolar cavities are filled with edema fluid, accompanied by a small amount of inflammatory cell infiltration, consistent with the lung changes of asphyxiation death.” He cut open the pulmonary artery and found no thrombus in the lumen. “The hilar lymph nodes are slightly enlarged and dark red, indicating congestion.”
The cardiac examination revealed more details. Zhang Lin carefully cut open the pericardium; the heart was about the size of the deceased's fist and weighed 320g, within the normal range. "Multiple punctate hemorrhages were visible under the epicardium," he pointed to the right atrial wall, "typical Tardieu spots, caused by capillary rupture during asphyxiation." Cutting open the left ventricular wall, the myocardium was 1.2cm thick, and the right ventricle 0.5cm. The myocardium was firm and dark red. "The myocardial fibers were neatly arranged, without rupture, necrosis, or old scars from myocardial infarction, ruling out death due to organic heart disease."
“Teacher Zhang, the blood is dark red and doesn’t clot,” Xiao Lin noticed the abnormality when collecting the blood sample. “Isn’t that a characteristic of death by asphyxiation?” Zhang Lin nodded and injected the blood into a test tube: “Lack of oxygen leads to increased activity of fibrinolytic enzymes in the blood, causing the blood to lose its clotting ability. Take 5 ml for toxicological analysis, focusing on common toxins such as sleeping pills, alkaloids, and organophosphates, and also test the carboxyhemoglobin saturation.”
During the abdominal dissection, the condition of the liver drew attention. "The liver is of normal size and weighs 1500g," Zhang Lin said as he cut open the liver tissue. The cut surface was dark red. "The lobular structure of the liver is clear, the central vein is dilated and congested, and the surrounding hepatocytes show vacuolar degeneration, which is a change in liver congestion caused by hypoxia." The gallbladder was full and contained about 30ml of yellowish-green bile. "The gallbladder mucosa is smooth and there are no stones."
The examination of the stomach contents provided important time clues. Zhang Lin cut open the stomach wall, and a smell of food mixed with gastric acid filled the air. There were about 200ml of semi-digested food residue in the stomach, including rice grains, beef fibers, broccoli fragments, and a small amount of red wine sediment. "The starch hydrolysis rate of the rice grains is about 60%, and the muscle fiber breakage length of the beef fibers is 0.8-1cm," he observed the sample under a microscope. "The degree of digestion is consistent with the state 4-6 hours after eating. Based on the analysis of the types of food, the last meal should have been dinner, including steak, vegetables, and red wine."
When extracting tissue samples from the stomach wall, Zhang Lin noticed a few pinpoint hemorrhages in the gastric mucosa. "The gastric fundus mucosa is congested," he explained. "This is a stress-induced change caused by vagal nerve excitation during asphyxiation, not mechanical damage." Xiao Lin aliquoted the gastric contents samples: "Samples have been taken for toxicological analysis and food type identification, and at the same time, we are testing for any gastric contents reflux."
The cranial anatomy revealed that the skull was intact without fractures. "There was no hemorrhage in the epidural space or subarachnoid space," Zhang Lin said, turning over the dura mater. "A small number of scattered punctate hemorrhages were visible in the subarachnoid space, mainly around the longitudinal fissure of the brain, consistent with intracranial changes in asphyxiation-related deaths." The brain tissue was dark red with significant edema. "The sulci were shallow, the gyri were widened, and the weight was 1450g, consistent with the characteristics of cerebral edema."
After collecting biological samples such as blood, urine, and bile, Zhang Lin summarized the preliminary autopsy results: "The deceased's death is consistent with mechanical asphyxiation, specifically manifested as: petechial hemorrhages in the conjunctiva of the eyelids, cyanosis of the lips, teeth marks on the tip of the tongue, Tardieu spots under the epicardium, acute pulmonary edema in both lungs, petechial hemorrhages in the gastric mucosa, and non-clotting of blood in the heart. After comprehensive correction, the time of death is estimated to be between 11 PM on May 14th and 1 AM on May 15th, with an error of ±1 hour."
"Can we determine the weapon used to injure you?" Xiao Lin asked, organizing the instruments, the scalpel gleaming under the light. Zhang Lin pointed to the hyoid bone and thyroid cartilage: "There's an incomplete fracture of the greater horn of the hyoid bone and subperiosteal hemorrhage at the superior horn of the thyroid cartilage, suggesting the weapon was a band-like object about 3-4 cm wide with soft edges, possibly a belt, tie, or rope. Combined with the footprints and cigarette butts found at the scene, the suspect should be male, 175-180 cm tall, physically strong, and likely cleaned up the scene after the crime."
When the last tissue sample was placed in formalin fixative, the label detailed information such as "left ventricular wall, HE staining" and "lower lobe lung, immunohistochemistry." Zhang Lin removed his gloves, the smell of disinfectant mingling with the pungent odor of formalin on his fingertips: "Once the toxicology analysis results are in and poisoning is ruled out, we can finally determine the cause of death." He looked at the body covered with a white sheet on the autopsy table. "The deceased's occupation is quite obvious," he suddenly remembered something, "the titanium alloy powder in the lining of the gray jacket, plus the red wine and steak in the stomach, suggests he was likely engaged in business or finance, and was of a relatively high social standing."
Xiaolin's pen flew across the anatomical record, the paper rustling: "Teacher Zhang, look at this electron microscope image of cardiomyocytes," she said, pulling up the image on the screen, "there are focal myofibril breaks, doesn't that also support myocardial damage caused by hypoxia?" Zhang Lin leaned closer to observe, the myofilaments on the image were disordered, and the Z-lines were blurred: "That's right, these are typical ultrastructural changes in hypoxic cardiomyocyte damage, further confirming the diagnosis of asphyxia."
The clock in the autopsy room pointed to four in the morning. Zhang Lin wrote "mechanical asphyxiation (most likely strangulation)" in the preliminary diagnosis section of the death certificate, with the time of death accurate to 11:30 PM on May 14th. Moonlight streamed through the blinds, casting dappled shadows on the floor, intertwining with the reflections of the instruments on the autopsy table, as if silently telling the story of the deceased's final struggles and suffering.
That evening, Xiao Zhou and his team were checking information on missing persons. Xiao Zhou's finger hovered over the keyboard for a moment before finally pressing Enter. Next to the entry "Li Gang, male, 38 years old, construction worker, missing May 12th," the word "Excluded" appeared on the screen. The DNA report from the skin tissue under the deceased's fingernails flashed in the lower right corner of the screen; three loci did not match Li Gang's information in the database, like an insurmountable chasm.
He took off his glasses and pressed his fingertip against his forehead; the fingerprints on the lenses blurred into indistinct circles under the light. From 8 p.m. last night until now, they have screened 875 pieces of information, spending an average of 3 minutes and 20 seconds on each, accumulating more than 48 hours of staring at the screen.
met free