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Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus

Broad intraorganic/vascular gas unassociated with cardiopulmonary resuscitation (CPR) in 65-year-old deceased man (case 9).CT scan obtained 12 hours and 20 minutes after death shows intraorganic/vascular gas throughout body (A-C, arrows). Gas is observed within lumens of right atrium and ventricle (A), and left femoral artery and vein (C). Intrahepatic gas is also observed (B), which is considered to be in hepatic vascular system. CPR was not performed because patient had do-not-resuscitate order. CT = computed tomography
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Figure 7: Broad intraorganic/vascular gas unassociated with cardiopulmonary resuscitation (CPR) in 65-year-old deceased man (case 9).CT scan obtained 12 hours and 20 minutes after death shows intraorganic/vascular gas throughout body (A-C, arrows). Gas is observed within lumens of right atrium and ventricle (A), and left femoral artery and vein (C). Intrahepatic gas is also observed (B), which is considered to be in hepatic vascular system. CPR was not performed because patient had do-not-resuscitate order. CT = computed tomography

Mentions: In case 9, broad areas of intraorganic/vascular gas were detected (Fig. 7). CPR was not performed because the patient had a do-not-resuscitate (DNR) order. Although there was no evidence of clinical sepsis in this case, the potential for sepsis during the agonal stage or for postmortem decomposition gas should be considered in similar cases. Radiologists should also inform pathologists of the presence of intraorganic/vascular gas on postmortem CT in order to help in the subsequent diagnosis, as this gas can never be found by autopsy. Notably, intraorganic/vascular gas is not always observed on postmortem CT, even in patients that received CPR or those with sepsis (15).


Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Broad intraorganic/vascular gas unassociated with cardiopulmonary resuscitation (CPR) in 65-year-old deceased man (case 9).CT scan obtained 12 hours and 20 minutes after death shows intraorganic/vascular gas throughout body (A-C, arrows). Gas is observed within lumens of right atrium and ventricle (A), and left femoral artery and vein (C). Intrahepatic gas is also observed (B), which is considered to be in hepatic vascular system. CPR was not performed because patient had do-not-resuscitate order. CT = computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499544&req=5

Figure 7: Broad intraorganic/vascular gas unassociated with cardiopulmonary resuscitation (CPR) in 65-year-old deceased man (case 9).CT scan obtained 12 hours and 20 minutes after death shows intraorganic/vascular gas throughout body (A-C, arrows). Gas is observed within lumens of right atrium and ventricle (A), and left femoral artery and vein (C). Intrahepatic gas is also observed (B), which is considered to be in hepatic vascular system. CPR was not performed because patient had do-not-resuscitate order. CT = computed tomography
Mentions: In case 9, broad areas of intraorganic/vascular gas were detected (Fig. 7). CPR was not performed because the patient had a do-not-resuscitate (DNR) order. Although there was no evidence of clinical sepsis in this case, the potential for sepsis during the agonal stage or for postmortem decomposition gas should be considered in similar cases. Radiologists should also inform pathologists of the presence of intraorganic/vascular gas on postmortem CT in order to help in the subsequent diagnosis, as this gas can never be found by autopsy. Notably, intraorganic/vascular gas is not always observed on postmortem CT, even in patients that received CPR or those with sepsis (15).

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus