FORENSIC ASSESSMENT OF LUNG AND LIVER INJURIES IN CAR ACCIDENTS

Аннотация

This article examines the forensic medical approaches to diagnosing and analyzing traumatic injuries to the lungs and liver resulting from road traffic accidents. It presents the pathophysiological mechanisms, injury classifications, and diagnostic methods used to identify both ante-mortem and postmortem trauma to these vital organs. Given the high incidence of thoracoabdominal trauma in vehicular collisions, the forensic interpretation of such injuries plays a critical role in determining the cause and mechanism of death, reconstructing the accident scenario, and establishing causal relationships between mechanical trauma and biological response. The study emphasizes the medico-legal value of autopsy findings, radiological imaging, histological evaluation, and biomechanical analysis incomprehensive forensic assessment. Kеywоrds: Forensic medicine, lung injury, liver trauma, car accidents, blunt force trauma, thoracoabdominal injury, medico-legal autopsy, biomechanics, cause of death, expert evaluation. INTRОDUСTIОN Road traffic accidents remain one of the leading causes of death and severe injury globally. According to World Health Organization (WHO) data, thoracic and abdominal injuries are present in up to 35–45% of fatal collisions. Among these, damage to the lungs and liver are among the most common and lethal due to their vital function and anatomical positioning. The lungs, occupying the thoracic cavity, are highly susceptible to rapid deceleration forces and compression, whereas the liver, being a dense, vascular organ in the upper right quadrant of the abdomen, is prone to rupture from blunt trauma, especially in frontal collisions[1]. From a forensic standpoint, accurate assessment of such injuries is crucial not only for determining the immediate cause of death but also for reconstructing the dynamics of the crash, evaluating seatbelt usage, and identifying potential medical malpractice or mechanical failure factors. The complexity of these injuries often necessitates an interdisciplinary approach involving forensic pathologists, radiologists, biomechanical experts, and traffic accident reconstruction specialists. MАTЕRIАLSАND MЕTHОDS The lungs are composed of soft, elastic tissue encased within the pleural cavities and protected by the rib cage. Despite this protection, they are vulnerable to pulmonary contusions, alveolar rupture, and hemothorax due to rapid changes in intrathoracic pressure. Direct compression from seatbelts or impact against the steering wheel can result in lung lacerations, pneumothorax, and bilateral hemorrhagic infiltration. Rib fractures commonly accompany such injuries and serveas both amarker and a cause ofsecondary trauma [2]. 98,7:ROTCAFTCAPMI.SECNEICSLACIDEM ,5202 ,lirpA,5emuloV gro.srehsilbupcimedaca.www The liver, due to its large mass, rich blood supply, and fragile capsule, is the most frequently injured solid organ in blunt abdominal trauma. Sudden deceleration causes the liver to shift relative to surrounding structures, resulting in lacerations, capsular rupture, subcapsular hematomas, and parenchymal fragmentation. In car accidents, the right lobe is more commonly affected dueto itsanatomical exposure. A significant concern in forensic practice is massive intra-abdominal hemorrhage, which may lead to rapid exsanguination and death before medical intervention. RЕSULTSАNDDISСUSSIОN In car accidents, kinetic energy transfer to the body results in varying injury patterns depending on crash dynamics. For the lungs, this includes compression between the chest wall and spine, leading to pressure-induced alveolar damage. Blast injuries from sudden airbag deployment or sudden chest compression can also cause barotrauma. In the liver, shearing forces during abrupt acceleration or deceleration events lead to rupture along anatomical planes, particularly near the ligamentum teres or hepatic veins. Coup- contrecoup effects may alsobe observed when theorgan impacts multiplesurfaces internally. Delayed rupture due to evolving hematomas is another forensic concern, especially in cases where survival lasted hours todays. Understanding these mechanisms helps forensic experts determine not just the presence of injury, but its timeline, severity, andcompatibility withthe described crash circumstances. In forensic medicine, a multi-modalapproach isused toassess lung and livertrauma [3]: Postmortem Autopsy: A detailed gross examination provides direct visualization of lacerations, contusions, hematomas, and hemorrhages. Lung tissues are checked for edema, congestion, and air leakage (bubbling). The liver is inspected for rupture patterns, hemorrhage volume, and bileduct integrity. Histopathology: Microscopic examination of tissues determines the vitality of injuries (whether they occurred ante-mortem or postmortem), identifies inflammatory responses, ischemia, andsigns ofmedical intervention. Imaging Studies: In living victims or where virtual autopsy (virtopsy) is used, CT scans