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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

Intramural gas in GI tract unassociated with CPR in 72-year-old deceased woman who did not undergo CPR (case 16).CT scan obtained 1 hour and 48 minutes after death shows intramural gas throughout GI tract (arrows) similar to case 15. CPR was not performed before death due to patient's DNR order. However, autopsy did not reveal any pathology associated with this postmortem CT finding. Therefore, intramural gas was attributed to mucosal injury, which is normal postmortem change. CPR = cardiopulmonary resuscitation, CT = computed tomography, DNR = do-not-resuscitate, GI = gastrointestinal
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Figure 14: Intramural gas in GI tract unassociated with CPR in 72-year-old deceased woman who did not undergo CPR (case 16).CT scan obtained 1 hour and 48 minutes after death shows intramural gas throughout GI tract (arrows) similar to case 15. CPR was not performed before death due to patient's DNR order. However, autopsy did not reveal any pathology associated with this postmortem CT finding. Therefore, intramural gas was attributed to mucosal injury, which is normal postmortem change. CPR = cardiopulmonary resuscitation, CT = computed tomography, DNR = do-not-resuscitate, GI = gastrointestinal

Mentions: In one patient who did not receive CPR (case 16), intramural gas was observed in the ascending colon on postmortem CT (Fig. 14). The microscopic examination and autopsy did not reveal any significant pathology associated with the intramural gas found on postmortem CT. Therefore, the gas was attributed to mucosal injury secondary to non-pathological postmortem change. As indicated by this particular case, the relationship between intramural gas in the GI tract on postmortem CT and antemortem CPR is not readily evident.


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)

Intramural gas in GI tract unassociated with CPR in 72-year-old deceased woman who did not undergo CPR (case 16).CT scan obtained 1 hour and 48 minutes after death shows intramural gas throughout GI tract (arrows) similar to case 15. CPR was not performed before death due to patient's DNR order. However, autopsy did not reveal any pathology associated with this postmortem CT finding. Therefore, intramural gas was attributed to mucosal injury, which is normal postmortem change. CPR = cardiopulmonary resuscitation, CT = computed tomography, DNR = do-not-resuscitate, GI = gastrointestinal
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 14: Intramural gas in GI tract unassociated with CPR in 72-year-old deceased woman who did not undergo CPR (case 16).CT scan obtained 1 hour and 48 minutes after death shows intramural gas throughout GI tract (arrows) similar to case 15. CPR was not performed before death due to patient's DNR order. However, autopsy did not reveal any pathology associated with this postmortem CT finding. Therefore, intramural gas was attributed to mucosal injury, which is normal postmortem change. CPR = cardiopulmonary resuscitation, CT = computed tomography, DNR = do-not-resuscitate, GI = gastrointestinal
Mentions: In one patient who did not receive CPR (case 16), intramural gas was observed in the ascending colon on postmortem CT (Fig. 14). The microscopic examination and autopsy did not reveal any significant pathology associated with the intramural gas found on postmortem CT. Therefore, the gas was attributed to mucosal injury secondary to non-pathological postmortem change. As indicated by this particular case, the relationship between intramural gas in the GI tract on postmortem CT and antemortem CPR is not readily evident.

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