Erdem HÖSÜKLER, Bilgin HÖSÜKLER, İpek ESEN MELEZ, Sermet KOÇ

İSTANBUL’DA 2007-2012 YILLARI ARASINDA YILDIRIM ÇARPMASINA BAĞLI ÖLÜMLER

Amaç: Yıldırım yaralanmaları, “örtü sistemi, kalp sistemi, merkezi sinir sistemi, gözler ve kulaklar, künt travma” dahil olmak üzere bazıları ölüme neden olabilen çeşitli yaralanmalara neden olabilir. Bu çalışmada yıldırım çarpması sonucu ölen 9 olgunun sunularak, olay yeri bulguları, otopsi bulguları ve histopatolojik bulguların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya dahil edilen 9 olgu (% 0,3) 2007 - 2012 yılları arasında İstanbul Adli Tıp Kurumu'nda otopsi yapılan toplam 24.755 olgunun dosyalarının retrospektif taranmasından elde edildi. Tüm olguların yaşı, cinsiyeti, olay yeri, olay sırasındaki koşullar, tanık ifadesi, deri lezyonları, otopsi bulguları, histopatolojik bulgular değerlendirildi. Bulgular: Olguların üçü (% 33,3) kadın, altı (% 66,7) olgu erkekti ve ortalama yaş 39,66 ± 13,36 (min: 18, maks: 56) idi. Ölümcül yıldırım düşmesi Nisan ve Eylül ayları arasında, ancak çoğunlukla Mayıs ayında meydana geldi. Otopside 4 vakada elektriksel çıkış yarası, 5 vakada ciltte yanık alanları, 2 vakada ciltte Lichtenberg figürü ve 4 vakada saçta yanık tespit edildi. Sonuç: Sonuç olarak yıldırım düşmesi nedeniyle yapılan otopsilerde spesifik olmayan bulgular sıklıkla saptanmaktadır. Bununla birlikte olay yeri incelemesi ve tanık ifadeleri bu olgularda doğru tanı koymada adli araştırmacılar için önemli argümanlardır. Ayrıca kişinin giydiği kıyafetlerin incelenmesi de tanı koymada önemli ipuçları sağlayabilir.

Anahtar Kelimeler:

Yıldırım çarpması, Ölüm, Otopsi, Adli tıp

Lightning Related Deaths In Istanbul, Between 2007-2012

Objective: Lightning injuries can cause a variety of injuries including “integumentary system, cardiac system, central nervous system, eyes and ears, and blunt trauma”, in which some of them may cause death. In this study, it was aimed to evaluate crime scene findings, autopsy findings and histopathological findings by presenting 9 cases that died due to lightning strike. Material and Methods: The 9 cases (0.3%) included this study were obtained from the screening of a total 24.755 cases that were performed autopsy at the Council of Forensic Medicine, Istanbul between 2007 – 2012. All cases’ age, gender, crime scene, circumstances during the event, witness statement, skin lession, autopsy findings, histopathological findings were evaluated. Results: Three (33.3%) cases were female and six (66.7%)cases were male, and the mean age was 39,66±13,36 (min:18, max:56). Fatal lightning strike occurred between April and September, but mostly in May. At autopsy, an external examination was revealed an electrical exit wound in 4 cases, burn areas on the skin in 5 cases, a Lichtenberg figure on the skin in 2 cases, and a burn in the hair surface in 4 cases. Conclusion: As a result, nonspecific findings are frequently detected in autopsies performed due to lightning strikes. However, crime scene investigation and the testimony of the witness may be the crucial indicative evidence for forensic investigators in getting an accurate diagnosis in cases of suspected lightning strikes. In addition, examining the clothes worn by victims provides important clues in diagnosis.

Keywords:

Lightning strike, Death, Autopsy, Forensic,

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Butun C, Beyaztas FY, Yılmaz R. Lightning-related death. Turk Arch Ped 2012;47:63-6.
Figgis P, Alvarez G. Delayed esophageal perforation following lightning strike: a case report and review of the literature. J Med Case Reports 2012;6:244.
Riviera J, Romero KA, Gonzalez-Chon O, Uruchurtu E, Marquez MF, Guevara M. Severe stunned myocardium after lightning strike. Crit Care Med 2007;35(1):280-5.
Ritenour AE, Morton MJ, McManus JG, Barillo DJ, Cancio LC. Lightning injury: A review. BURNS 2008;34(5);585-94.
Gatewood MO, Zane RD. Lightning injuries. Emerg Med Clin N Am 2004;22(3):369-403.
Cooray V, Cooray C, Andrews CJ. Lightning caused injuries in humans. J Electrostatics 2007;65(5-6):386-94.
Lakshminarayanan S, Chokroverty S, Eshkar N, Grewal R. The spianl cord in lightning injury: A report of two cases. J Neurol Sci 2009;276(1-2):199-201.
Saglam H, Yavuz Y, Yurumez Y, Ozkececi G, Kilit C. A case of acute myocardial infarction due to indirect lightning strike. J Electrocardiol 2007;40(6):527-30.
Nagesh IV, Bhatia P, Mohan S, Lamba NS, Sen S. A bolt from the blue: Lightning injuries. Med J Armed Forces India. 2015;71(Suppl 1): S134-7.
Zack F, Rotschild MA, Wegener R. Ligntning Strike-Mechanisms of Energy Transfer, Cause of Death, Types of Injury. Dtsch Arztebl 2007;104(51-52):A3545-9.
Myung NS, Lee IW, Goh EK, Kong SK. Cochlear implantation for severe sensorineural hearing loss caused by lightning. Am J Otolaryngol. 2012;33(6):767-769.
Jensenius JS. A detailed analysis of recent lightning deaths in the United States. Fifth International Lightning Meteorology Conference, Tucson, USA. Vol. 2021. 2014.
Pfortmueller CA, Yikun Y, Haberkern M, Wuest E, Zimmermann H, Exadaktylos AK. Injuries, sequelae, and treatment of lightning-induced injuries: 10 years of experience at a Swiss Trauma Center. Emerg Med Int. 2012;2012:167698.
Gadge, SJ, Shrigiriwar MB. Lightning: a 15 year study of fatal cases at SVNGMC Yavatmal. J. Forensic Med. Sci. Law 2013;22(1):1-5.
Blumenthal R. Lightning fatalities on the South African Highveld: a retrospective descriptive study for the period 1997 to 2000. Am J Forensic Med Pathol. 2005;26(1):66-9.
Hekimoglu Y, Asirdizer M, Demir U, Gur A, Etli Y, Gumus O, Kartal E. An Autopsy Series: Lightning-Related Deaths in Van and Hakkari Provinces. West Indian Med J. 2017. DOI: 10.7727/wimj.2016.588 cited at: https://pdfs.semanticscholar.org/9fd3/a5a018fc5fd4f1b6a2.
Akkaya H, Karbeyaz K, Kokcuoglu MA, Urazel B. Lİghtning Associated Deaths During 1997 - 2011 In Eskisehir. J For Med 2013;27(2):94-99.
Pincus JL, Lathrop SL, Briones AJ, Andrews SW, Aurelius MB. Lightning deaths: a retrospective review of New Mexico’s cases, 1977-2009. J Forensic Sci. 2015;60(1):66‐71.
Yanagawa S, Yamanoto K, Naito Y, Takahashi N, Matsui M. Investigations of lightning accidents on automobiles Electr.Power Syst. Res. 2016;139:2-9.
Mulder MB, Msalu L, Caro T, Salerno J. Remarkable rates of lightning strike mortality in Malawi. PLoS One. 2012;7(1):e29281.
Turan N, Birincioglu İ, Butun C, Muhammet C. Findings in Fatal Lightning Strike Cases. Turkiye Klinikleri J Foren Med 2011;8(2):59-65.
Davis C, Engeln A, Johnson EL, McIntosh SE, Zafren K, Islas AA, McStay C, Smith WR, Cushing T. Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness Env Med. 2014;25(4 Suppl):S86-95.
Wankhede AG, Agrawal VR, Sariya DR. An injury subjacent to lac ornament in a case of lightning. Forensic Sci Int. 2010 25;195(1-3):e9-12.
Murty OP. Dramatic lightning injury with exit wound. J Forensic Leg Med. 2007;14(4):225-7.
Ocak T, Duran A, Tekelioglu UY, Demirhan A, Bekdaş M, Cetin A. Two cases of lightning strikes resulting in Lichtenberg figures. Dermatologica Sinica 2014; 32(1):37-38.
McIntyre WF, Simpson CS, Redfearn DP, Abdollah H, Baranchuk A. The lightning heart: a case report and brief review of the cardiovascular complications of lightning injury. Indian Pacing Electrophysiol J. 2010;10(9):429‐434.
Nelson KL, Mills W Jr, Umbel S, Crosson JE, Shaffner DH, Hunt EA.Lightning, sudden cardiac death, simulation and an automated external defibrillator: the perfect storm. Resuscitation. 2007;74(3):567-571.
Levy DR, Akiyama T.Lightning-induced ventricular fibrillation. Cardiol J. 2007;14(1):91-94.
Wankhede AG, Sariya DR. Damage due to lightning when it strikes the face. Forensic Sci Int. 2013 10;224(1-3):e1-3.
Ventura F, Barranco R, Bonsignore A, De Stefano F. A Unusual Lightning Death in an Indoor Setting: A Case Report. Am J Forensic Med Pathol. 2017;38(1):1-4.
Dogan KH, Demirci S, Günaydın G. Deaths caused by lightning strike: Case report of three cases. Genel Tıp Derg 2007;17(4):217-222.
Rahmani SH, Faridaalaee G, Jahangard S. Acute transient hemiparesis induced by lightning strike. Am J Emerg Med. 2015;33(7):984.e1-3.
Lizano-Díez X, Alentorn-Geli E, León-García A, Marqués-López F. Fracture of the femoral component after a lightning strike injury: A case report. Acta Orthop Traumatol Turc. 2017;51(1):84-87.
Ozgun B, Castillo M. Basal Ganglia Hemorrhage Related to Lightning Strike. AJNR Am J Neuroradiol. 1995;16(6):1370-1.