Forensic Biomechanics and Pathophysiological Trajectory of Lethal Multiple Sharp Force Injuries: An Observational Analytic Case Study with Weapon Deformation and Letulle Autopsy Reconstruction

Abstract

Background. Homicidal multiple stabbing raises forensic questions about wound sequence, weapon–wound concordance, and the speed of collapse.

Objective. To reconstruct a fatal homicidal multiple stabbing in a public place, focusing on weapon deformation, visceral wound tracts, and acute shock.

Methods. A complete Letulle en masse autopsy was performed at Dr. Soetomo General Hospital, Surabaya, Indonesia, under Article 133 of the Indonesian Criminal Procedure Code (KUHAP). Wound morphometry, visceral tract measurement, blood-loss modeling, and weapon biomechanics were analyzed.

Results. Twenty-three sharp force injuries involved the back (n = 11), chest (n = 4), neck (n = 3), upper extremities (n = 3), and left shoulder and flank (n = 2). Dissection showed complete transection of the right internal jugular vein; a left lower lung laceration with 450 mL hemothorax (10th intercostal space; tract depth 5.5 cm); and right lower lung and hepatic dome perforation with 400 mL hemothorax (12th intercostal space; tract depth 9.0 cm). Total acute blood loss was 2,700–2,950 mL (42.8%–46.8% of circulating volume), meeting Advanced Trauma Life Support (ATLS) criteria for Class IV hemorrhagic shock. The 15.0 cm single-edged kitchen blade showed plastic bending (θ ≈ 112°), consistent with an off-axis force exceeding its estimated 48–72 N yield threshold on impact with the 12th rib.

Conclusion. Death resulted from Class IV hemorrhagic shock combined with bilateral compressive hemothorax, pulmonary atelectasis, and terminal asphyxia. Letulle autopsy with biomechanical weapon–wound correlation provides objective evidence for homicide reconstruction.