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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

Hyperdense wall of GI tract in 74-year-old deceased woman (case 13).A. CT scan obtained 2 hours and 34 minutes after death shows hyperdense walls throughout GI tract (arrows). B, C. Autopsy revealed that hyperdense GI wall was intramural hemorrhage (B, macroscopic image; C, microscopic low-power view image with hematoxylin and eosin stain). CT = computed tomography, GI = gastrointestinal
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Figure 11: Hyperdense wall of GI tract in 74-year-old deceased woman (case 13).A. CT scan obtained 2 hours and 34 minutes after death shows hyperdense walls throughout GI tract (arrows). B, C. Autopsy revealed that hyperdense GI wall was intramural hemorrhage (B, macroscopic image; C, microscopic low-power view image with hematoxylin and eosin stain). CT = computed tomography, GI = gastrointestinal

Mentions: Compared to the GI lumen, intramural hemorrhage in the GI tract is difficult to diagnose, even on AMCT (53). When fluid within the GI tract is water-dense, the GI wall density is typically high on postmortem CT. However, a hyperdense GI wall on postmortem CT should be evaluated carefully because it can indicate intramural hemorrhage. For example, in case 13, hyperdense walls were widespread throughout the GI tract (Fig. 11A). This finding was identified as intramural hemorrhage on the subsequent autopsy (Fig. 11B, C).


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)

Hyperdense wall of GI tract in 74-year-old deceased woman (case 13).A. CT scan obtained 2 hours and 34 minutes after death shows hyperdense walls throughout GI tract (arrows). B, C. Autopsy revealed that hyperdense GI wall was intramural hemorrhage (B, macroscopic image; C, microscopic low-power view image with hematoxylin and eosin stain). CT = computed tomography, GI = gastrointestinal
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 11: Hyperdense wall of GI tract in 74-year-old deceased woman (case 13).A. CT scan obtained 2 hours and 34 minutes after death shows hyperdense walls throughout GI tract (arrows). B, C. Autopsy revealed that hyperdense GI wall was intramural hemorrhage (B, macroscopic image; C, microscopic low-power view image with hematoxylin and eosin stain). CT = computed tomography, GI = gastrointestinal
Mentions: Compared to the GI lumen, intramural hemorrhage in the GI tract is difficult to diagnose, even on AMCT (53). When fluid within the GI tract is water-dense, the GI wall density is typically high on postmortem CT. However, a hyperdense GI wall on postmortem CT should be evaluated carefully because it can indicate intramural hemorrhage. For example, in case 13, hyperdense walls were widespread throughout the GI tract (Fig. 11A). This finding was identified as intramural hemorrhage on the subsequent autopsy (Fig. 11B, C).

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