Patterned bruising indicating a complete renal artery transection in a fatal occupational accident

Bilateral Renal Infarction, a Rare Consequence of Blunt Renal Artery Injury: A Case Report

Background

Renal infarction is an uncommon complication of Blunt renal artery injury (BRAI) following abdominal trauma. Diagnosis of infarction is difficult and mostly delayed due to non-specific symptoms. Early diagnosis can lead to appropriate and effective treatment, which prevents further complication.

Case presentation

We report a case of 21-year-old man falling from a height of 9 m. A contrast-enhanced CT scan in the nephrogram phase showed no evidence of absorption in the right kidney and significantly decreased absorption in the left kidney. The pyelogram phase showed no secretion in the right kidney and decreased secretion in the left kidney suggesting segmental renal infarction. Subsequently, heparin infusion was initiated immediately. A follow-up contrast- enhanced abdominopelvic CT scan was performed after 1 month and showed no sign of infarction, and all laboratory tests were normal.

Conclusion

Contrast-enhanced abdominopelvic CT scan helps physicians diagnose the renal infarction immediately and start appropriate treatment. Treatment can vary from aggressive surgical procedures to observation and supportive care.

Fatal work-related injuries in the Genoa district (North-Western Italy): Forensic analysis of the 10-year period between 2011 and 2020

According to the ILO (International Labor Organization), an occupational accident is that which occurs in the course of work and results in either a fatal or non-fatal injury. Occupational-related deaths are increasingly a concerning issue, also worldwide, with severe social repercussions: it is clear that when a person loses their life, it has a permanent impact on all their family, as well as incurring direct and indirect costs for employers, workers and the community at large. The aim of the present retrospective-observational study is to investigate, from an autoptic and forensic point of view, the characteristics of occupational-related deaths of victims received between the 10-year period of 2011-2020 by the Municipal Morgue of Genoa, which forms part of the Institute of Forensic and Legal Medicine, for the purpose of providing a Forensic and Coroner's overview of this important phenomenon. The study comprises of a list of 47 people who died as a result of an occupational injury: 46 males and 1 female. It was observed that workers in the construction and steel manufacturing industries were in the category most at risk of fatal accidents (40.5%). In 41 cases (87.2%), death was related to major mechanical trauma, from falling from a height (42.5%) objects falling directly onto the victim (38.3%) and lastly, from pedestrian road accidents (6.4%). Fatal head traumas with endocranial haemorrhage accounted for deaths in 23 of all the cases studied (63.4%). As shown in our study, death in the workplace is still today having to be considered as an important social issue and it is still necessary to improve the workers' knowledge of the related hazards and risks involved at work, together with preventative procedures. An in-depth analysis of such risks in the workplace, as well as the monitoring and training of workers is fundamental if we are to achieve an overall improvement in working conditions.