Child sexual homicide and sexual sadism: Autopsy analysis of live encasement followed by survival

We report the case of an 8-year-old girl who, having been reported missing, was found while concealed in a bed storage compartment in her neighbour’s house. Despite medical intervention she died 13 hours later. Autopsy revealed sexual and physical assault with multiple incised and blunt force injuries, signs of possible restraint, torture and evidence of concealed trauma. Our report discusses the forensic interpretation of findings and the contributory roles of haemorrhagic shock and positional asphyxia. It demonstrates the pivotal function of forensic autopsy in unravelling what occurred in sequence of events. It was a complex medico-legal challenge with the need to record multiple injuries including genital ones. The case required meticulous documentation of all forensic findings and challenges and demonstrates the need for stricter punishments and more informed policy making for effective child protection.