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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

Non-hemorrhagic hyperdense fluid in colon in 72-year-old deceased woman (case 12).CT scan obtained 1 hours and 48 minutes after death shows hyperdense content in colon (arrow) similar to case 11. However, this material was not hemorrhagic on subsequent autopsy. It was unclear based on patient's medical history whether she was administered oral contrast medium or other oral medication, such as laxative. Residual contrast material is also observed in kidneys of cases 12 and 16 because contrast-enhanced CT was performed immediately before death. CT = computed tomography
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Figure 10: Non-hemorrhagic hyperdense fluid in colon in 72-year-old deceased woman (case 12).CT scan obtained 1 hours and 48 minutes after death shows hyperdense content in colon (arrow) similar to case 11. However, this material was not hemorrhagic on subsequent autopsy. It was unclear based on patient's medical history whether she was administered oral contrast medium or other oral medication, such as laxative. Residual contrast material is also observed in kidneys of cases 12 and 16 because contrast-enhanced CT was performed immediately before death. CT = computed tomography

Mentions: Two other types of hyperdense GI fluids were observed in cases 11 and 12. In case 11, the colon contained mildly hyperdense fluid on the postmortem CT (Fig. 9), which was identified as a hemorrhage on autopsy. His medical records indicated that he was receiving anticoagulant medication and thus at risk of hemorrhage. In case 12, the colon contained extremely hyperdense contents (Fig. 10). The material was not hemorrhagic on autopsy, and its identity was unclear. It was also unclear whether the patient was administered a laxative or oral contrast medium antemortem. These cases highlight the difficulty in determining the source of hyperdense GI fluid using postmortem CT alone.


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)

Non-hemorrhagic hyperdense fluid in colon in 72-year-old deceased woman (case 12).CT scan obtained 1 hours and 48 minutes after death shows hyperdense content in colon (arrow) similar to case 11. However, this material was not hemorrhagic on subsequent autopsy. It was unclear based on patient's medical history whether she was administered oral contrast medium or other oral medication, such as laxative. Residual contrast material is also observed in kidneys of cases 12 and 16 because contrast-enhanced CT was performed immediately before death. CT = computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 10: Non-hemorrhagic hyperdense fluid in colon in 72-year-old deceased woman (case 12).CT scan obtained 1 hours and 48 minutes after death shows hyperdense content in colon (arrow) similar to case 11. However, this material was not hemorrhagic on subsequent autopsy. It was unclear based on patient's medical history whether she was administered oral contrast medium or other oral medication, such as laxative. Residual contrast material is also observed in kidneys of cases 12 and 16 because contrast-enhanced CT was performed immediately before death. CT = computed tomography
Mentions: Two other types of hyperdense GI fluids were observed in cases 11 and 12. In case 11, the colon contained mildly hyperdense fluid on the postmortem CT (Fig. 9), which was identified as a hemorrhage on autopsy. His medical records indicated that he was receiving anticoagulant medication and thus at risk of hemorrhage. In case 12, the colon contained extremely hyperdense contents (Fig. 10). The material was not hemorrhagic on autopsy, and its identity was unclear. It was also unclear whether the patient was administered a laxative or oral contrast medium antemortem. These cases highlight the difficulty in determining the source of hyperdense GI fluid using postmortem CT alone.

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