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Pathology Update 2025
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Scientific Session - Clinical Forensic Medicine

Scientific

Scientific

3:30 pm

22 February 2025

Meeting Rooms 101 & 102

Discipline Streams

Clinical Forensic Medicine

Chairs

Session Scientific Program

Vanita Parekh1
1Canberra Hospital

Objective
Lid and conjunctival injuries (LACI) frequently occur during assault and are often accompanied by non-fatal strangulation. 

LACI mandate comprehensive eye examination and should be systematically photographed. 

Method
An analysis of LACI in a clinical audit of 85 sequential non-sexual assault presentations. 

Results
LACI was present in 26.9% of general assault cases, and 47.4% of LACI patients also experienced non-fatal strangulation (NFS). LACI was sustained in the context of domestic family violence (DFV) in 62.9% of cases. Females made up 69.2% of LACI patients, with those between 14 and 29 years most at risk. Children were present in 12.8% of cases, 78.2% of perpetrators were male, and 44.9% of patients had previously been assaulted by the same perpetrator.

Conclusions
LACI is frequently associated with NFS and/or DFV. Since NFS increases future homicide attempts and events more than 6-fold, LACI is an important signal about a patient’s homicide risk, expanding the dimensions of the care needed. Those experiencing LACI during an assault also need to be referred for comprehensive eye examination as soon as possible. With consent, systematic forensic photography of LACI enables its assessment and documentation, which assists the legal process. These conclusions should drive legislative consideration and reform, plus expanded education for clinicians and police.
Lyndal Bugeja1
1Monash University

Background: It has been established that up to 50% of patients reporting neck compression do not show any external physical injuries. Guidelines have been developed to direct the assessment of “red flag” symptoms and inform referrals for diagnostic imaging to detect internal injuries. This study sought to synthesise the findings of published studies that examined patients reporting neck compression in the context of interpersonal violence.
Methods: A systematic literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. A search strategy was developed using key and indexed terms combined using Boolean operators. The search strategy was applied to five electronic reference databases and results exported to a systematic review software program for screening against a pre-determined eligibility criteria.
Results: The search yielded 482 results of which 35 studies were eligible. Among these 35 studies, one was a case-control, 15 were cross-sectional and 19 were case reports. The findings from these studies will be examined using a narrative synthesis to report: the presence and nature of signs and symptoms and “red flag” signs and symptoms; the performance of, type and findings from diagnostic tests; and the utility of these findings in criminal justice responses. 
Fernando Pisani1
1Forensic Medical Unit, WSLHD & NBMLHD

Case presentation and discussion around the challenges of assessing, investigating and managing victims of NFS in the ED.

Resources