Homicidal penetrating incised wounds of the thorax. An autopsy study of 52 cases.

During March-June and August-September 1981, 245 medicolegal autopsies were conducted by the author at the Johannesburg and Diepkloof government mortuaries. In 52 cases (21.2%) penetrating incised wounds of the thorax were found to be the cause of death. These involved diverse and often multiple thoracic structures - ventricles, atria, interventricular septum, lungs, and, in particular, blood vessels. In most of these cases death was ascribed to either exsanguination and the attendant hypovolaemic shock or, in those wounds involving the pericardium and myocardium, cardiac tamponade. Several findings emerged from this study: (i) an abysmally low number of the victims (5.8%) reached a medical facility alive; (ii) no females were seen, and the 21-30 year age group predominated (46.2%); (iii) 80.8% had arrived at the casualty department during a weekend; (iv) 71.2% had received a single fatal penetrating incised wound; (v) nearly two-thirds of the wounds seen were inflicted over the precordial area; (vi) almost 80% of the victims had a positive blood alcohol level, this ranging from 10 mg/dl to 340 mg/dl; (vii) there was a paucify of blunt force injuries in addition to the primary penetrating incised would/s; and (viii) there was a low percentage of 'defence' wounds among these victims of homicidal assaults.