Timing gastroenteric perforations : statistical meaning of histomorphologic data and sensibility of the histocronologic method

Chronology of lesions represents a theme forensic pathology has always paid great attention to; its employment in fact allows to ascribe or exclude penal and civil liability concerning medical behavior. Objective: the aim of this study has been to verify the statistical meaning of histomorphologic data and the sensibility of the histocronologic method in timing gastroenteric perforations. Nature of the study: it is a retrospective histomorphologic study formed on tissues taken in surgical treated perforation cases. Materials and methods: alla cases of spontaneous and traumatic gastroenteric perforations, that underwent surgical operation in the Emergency Department of Niguarda Hospital in Milan between 1980 and 2000 have been reviewed. through the inspection of clinical records of the hospital archives, alla cases in which perforation time was known have been selected. Routine histochemical stain (Hematoxyline-eosine) and speciales (Masson's Trichromic, Perls and carstair) have been performed the relative histological material. Each prepared slide has been blindly and separately examined by more pathologists, who kept to uniform and agreed criteria in describing the inflammatory reaction pointed out. Conclusions: first of all, qualitative and quantitative histomorphologic findings have been correlated to the known perforation times and have been analyzed in order to assess their statistical meaning in dating perforations. Besides, the same histological evidences have been dated by using classical histochronologic criteria for the purpose of verifying sensibility of such a firm method when it's applied to gastroenteric perforations.