NCJ Number
229291
Journal
Journal of Forensic Sciences Volume: 54 Issue: 6 Dated: November 2009 Pages: 1447-1449
Date Published
November 2009
Length
3 pages
Annotation
This paper reports on a case in which a 22-year-old man found dead after continued sitting in a reclining chair for 2 years was determined to have died from a long-term abnormal lifestyle that caused fatal elephantiasis.
Abstract
The central feature for the pathogenesis of elephantiasis is chronic lymph edema, which is commonly a result of lymphatic obstruction that leads to impaired drainage and accumulation of interstitial fluid. A long-term sitting posture is reported to cause chronic lymph edema in the lower limbs. Keeping a seated posture obstructs the lymph vessels due to bending of the groin and the decreasing return flow of lymph by inducing muscular atrophy, which finally results in the outbreak of lymph edema. Chronic lymph edema produces an increase in the number of fibroblasts and keratinocytes in the edematous tissue, leading to elephantiasis on the surface of the skin. In the case reported, the man had consumed an unbalanced diet, continued to wear the same pair of socks, and never washed himself for the 2 years while seated in the chair. His skin of bilateral crura developed into elephantiasis with severely festered ulcers on its surface. At autopsy, subcutaneous edema was significant in his lower limbs, and chronic circulatory disturbance of lymphoducts and veins was observed histologically. There were no critical findings that accounted for chronic edema in the lower limbs. Oligotrophia and dirt on his limbs might have exacerbated the chronic edema in elephantiasis. 2 figures and 10 references