Cadaveric blood is ubiquitous, and observed in various forms—liquid, coagulated, and clot-like—during autopsies. Understanding its state in postmortem vessels is essential for both scientific research and forensic investigations. Pulmonary thromboembolism (PT) is a leading cause of sudden death, often requiring medicolegal evaluation. While thrombus formation is primarily explained by Virchow’s triad, the distinction between antemortem, agonal, and postmortem clot (PMC) pathogenesis remains debated. This study aims to systematically review the literature to clarify the morphological and pathological differences among these entities in forensic practice. A systematic review of PubMed, Science Direct, Scopus, and Web of Science was conducted using predefined key terms: “clot,” “thrombus,” “chicken-fat,” “agonal,” “postmortem,” and “autopsy.” Articles were screened for relevance, and 11 studies meeting the inclusion criteria were analyzed. The review highlights a significant gap in comparative studies addressing antemortem versus postmortem clots. The literature lacks a consensus regarding their definitions, macroscopic and microscopic characteristics, pathogenesis, and relevance to determining the cause and timing of death. Existing studies present conflicting interpretations, limiting the reliability of forensic differentiation. The current understanding of antemortem, agonal, and postmortem clots remains incomplete. Our findings underscore the need for further research to establish standardized criteria for distinguishing clot types, which is crucial for forensic pathology and medicolegal evaluations.

Background: Digital pathology (DP) and whole-slide imaging (WSI) are increasingly utilized in clinical pathology; however, their role in forensic medicine remains less defined, as evidentiary standards demand robust validation, auditability, and a chain of custody. Methods: We conducted a systematic review of PubMed, Scopus, and Web of Science for studies that applied DP and WSI to forensic, autopsy, or postmortem contexts, with eligibility requiring peer-reviewed human studies that reported methods and outcomes. Data were charted for study design, tissue, devices/software, and outcomes (diagnostic agreement, quantitative metrics, validation/quality assurance (QA)). Results: The search retrieved 361 records; after screening and full-text assessment, 21 studies were selected for inclusion. Fifteen studies primarily advanced diagnostic knowledge using postmortem material (e.g., quantitative neuropathology and organ-specific morphometry), while five had direct forensic aims (casework validation or core forensic tests). Conclusions: The review highlights that DP is technically ready for medico-legal workflows; however, its use remains low compared to other clinical settings. Adoption in forensics should centre on CAP-style, use–case–specific validation, traceable/auditable pipelines (including hashing, logs, and tile-linked overlays), stain/colour governance, and external robustness testing. Under these conditions, DP can deliver reproducible, transparent, and court-defensible evidence across forensic practice.

Restrictions imposed during the COVID-19 pandemic might have changed recreational habits. In this study, the results of toxicological tests for alcohol and drugs in blood were compared among drivers stopped at roadside checks in the periods before (1 January 2018 to 8 March 2020) and after the lockdown measures (9 March 2020 to 31 December 2021). A total of 123 (20.7%) subjects had a blood alcohol level above the legal limit for driving of 0.5 g/l, 21 (3.9%) subjects tested positive for cocaine, and 29 (5.4%) subjects positive for cannabis. In the COVID-19 period, the mean blood alcohol level was significantly higher than in the previous period. Cannabis use, which was more frequent among younger subjects, was statistically associated with cocaine use. There has also been a quantitative increase in alcohol levels in the population with values above the legal limits, indicative of greater use of alcohol in the population predisposed to its intake.

Fat embolism syndrome (FES) can be challenging to diagnose by forensic pathologists. For the diagnosis of FES, there is no benchmark test. Postmortem diagnosis requires a full autopsy and specific ancillary examination. However, the high variability in the clinical presentation of FES represents a relevant issue, and there is no consensus on the postmortem assessment. This is the case of a 33-year-old man who died of FES one week after a car accident. He suffered multiple fractures, but was hemodynamically stable and showed no neurological changes. The patient died a few days after hospital discharge. Additionally, he had osteogenesis imperfecta type III, a genetic disorder associated with bone fragility. To the best of our knowledge, no study has assessed whether and how osteogenesis imperfecta contributes to the onset of FES. Despite the heterogeneous manifestations of FES, the present case met many of the proposed clinical and histological diagnostic criteria. Therefore, we briefly review FES diagnostic criteria, show the postmortem diagnostic workup, and discuss the hypothetical link between osteogenesis imperfecta and FES.

Defense wounds generally occur when a victim attempts to protect vital organs and blood vessels during an assault, and are therefore typically located on the forearms or hands. Gunshot-induced defense wounds are less frequent compared to stab wounds, which have been extensively described in the literature. We present three cases where victims unsuccessfully attempted to defend themselves from gunshots, and where the detailed description of injuries played a key role in the reconstruction of the crime scenes. In the first case, a man was shot with a smooth-bore shotgun, presenting a “through-and-through” gunshot wound on the lateral surface of the left forearm and a large gaping wound on the posterior surface of the same forearm. The second and third cases involved two men who were shot with handguns. The first displayed an entrance wound on the dorsal surface of the right hand, with burned edges and smoke soiling, and an exit wound on the palmar surface. The second case involved two wounds on the left hand: one on the dorsum and the other on the palm. To the best of our knowledge, few studies in the literature emphasize the role of gunshot defense wounds in aiding the reconstruction of crime dynamics. The cases presented in this study highlight the importance of precisely defining the pathological and morphological features of the wounds, as well as the bullet trajectories, to accurately identify defense wounds. These findings are valuable for reconstructing the dynamics of the assault and providing critical information to the public prosecutor.