Car-to-pedestrian accident with a unique decollement injury

The authors present a unique case of decollement injury found on an 85-year-old victim that was run-over by a tank truck. While external examination evidenced multiple severe injuries, autopsy confirmed the preliminary findings and revealed also the presence of an extensive decollement that spread from the left hemithorax to a wound on the left ankle, through which parts of the small intestines and pertaining mesentery protruded. The article offers an interpretation of the injuries sustained by the victim, focusing on the most probable decollement mechanism. The forensic pathologist in this case could rely also on the valuable help of surveillance cameras of a nearby bank office that helped to better understand the events that brought to the fatal injuries. The authors concluded that the expulsion of the jejunum was produced by a combination of two movements: a forward passage that created the decollement and detachment of the jejunum and a backward movement that completed the expulsion of the jejunum through the open fracture of the ankle. This case report evidences the importance of the forensic pathologist and a correct and detailed investigation of injuries in reconstructing an accident, as well that of surveillance cameras as investigation tool in forensic cases.