USING HISTOLOGICAL METHODS IN FORENSIC MEDICAL PRACTICE FOR DETERMINATION OF THE AGE OF INJURY TO THE PANCREAS

The purpose of the work was to study the dynamics of changes in the histological parameters of the pancreas traumatic tissues in various types of mechanical injuries depending on the prescription of caused injuries. The material for the study included tissues of 64 male and female pancreases, aged from 20 to 60 who died at a known and an unknown time of injury with and without alcohol in blood. These people were subjected to autopsy in anatomical department of Forensic Medical Examination Bureau in Lugansk region. In the conducted research we used histological and histochemical techniques to detect dynamic processes of regeneration histological parameters of pancreas injured tissues and performed statistical analysis of the results. According to our data, the thoraco-abdominal injury from the pancreas damage showed at the histological examination (up to 6 hours from the moment of injury) red blood cells with clear contours, leukostasis in vessels, leukocyte accumulation perivascularly, and leukocyte hemorrhages located in diffuse spaces of the injury zone. Stromal edema was also detected. Symptoms of fatty necrosis began to appear. 6-12 hours after injury, the hemorrhage got the form of a cluster of erythrocytes with clear contours, but erythrocytes in the center of hemorrhages were fuzzy, the number of leukocytes in the blood vessels and tissues increased, and concentrated perifocally. In some cases, hemorrhages were detected in the adipose tissue, which was located around the pancreas, with neuroticism of the parenchyma of the pancreas, which was adjacent to the aforementioned zone. After 12-24 hours, erythrocytes turned into granular masses; cells of necrotic tissues appeared on the spot. In the foci of perifocal inflammation, leukocytes reveal macrophages, lymphoid cells that contained intracellular granular pigment (hemosiderin). Edema was distributed. Inflammatory infiltration increased simultaneously and the number of fatty necrosis, on the contrary, decreased. On the 2-3 days, the demarcation line around the parenchymal necrosis and surrounding adipose tissue was well distinguished. In this period there was a well-developed widespread leukocyte infiltration, a large number of fatty necrosis, and the swelling was spreading. In infiltrates among leukocytes there were lymphocytes, macrophages, isolated histiocytes. In the period of 4-6 days after the injury the number of fatty necrosis continued to increase, the number of lymphocytes, macrophages, histiocytes in the infiltration zone increased. This was the moment of the demarcation line emerging. After 6 days the exclusion of necrotic tissue began in the injury zone with the transformation of the peripheral cell infiltration into the lymphostiocyte. There was proliferation of fibroblasts in the walls of capillaries, which lasted for 1-2 weeks. After the first 2 weeks, we could observe a consistent proliferation of fibroblasts, and the formation of delicate connective tissue fibers. Young blood vessels started to appear. The obtained research results indicate that our data coincide with literary sources, which indicate that traumatic damage to the pancreas is characterized by high lethality ranging from 15 to 40% (literary data) and up to 28% according to our data. In the course of the study, we established natural changes in histological parameters of pancreatic tissue, depending on the prescription of injury, taking into account the time of death, the presence of a traumatic illness, etc. These parameters help the forensic investigator in solving the urgent issues of deciding the prescription of injury and the sequences of events causing damage to the injured and dead people with mechanical trauma.