Background: To analyze diagnostic accuracy of prompt post mortem Computed Tomography (pmCT) in determining causes of death in patients who died during trauma room management and to compare the results to gold standard autopsy during office hours.
Methods: Multiple injured patients who died during trauma room care were enrolled. PmCT was performed immediately followed by autopsy during office hours. PmCT and autopsy were analyzed primarily regarding pmCT ability to find causes of death and secondarily to define exact causes of death including accurate anatomic localizations. For the secondary analysis data was divided in group-I with equal results of pmCT and autopsy, group-II with autopsy providing superior results and group-III with pmCT providing superior information contributing to but not majorly causing death.
Results: Seventeen multiple trauma patients were enrolled. Since multiple trauma patients were enrolled more injuries than patients are provided. Eight patients sustained deadly head injuries (47.1%), 11 chest (64.7%), 4 skeletal system (23.5%) injuries and one patient drowned (5.8%). Primary analysis revealed in 16/17 patients (94.1%) causes of death in accordance with autopsy. Secondary analysis revealed in 9/17 cases (group-I) good agreement of autopsy and pmCT. In seven cases autopsy provided superior results (group-II) whereas in 1 case pmCT found more information (group-III).
Discussion: The presented work studied the diagnostic value of pmCT in defining causes of death in comparison to standard autopsy. Primary analysis revealed that in 94.1% of cases pmCT was able to define causes of death even if only indirect signs were present. Secondary analysis showed that pmCT and autopsy showed equal results regarding causes of death in 52.9%.
Conclusions: PmCT is useful in traumatic death allowing for an immediate identification of causes of death and providing detailed information on bony lesions, brain injuries and gas formations. It is advisable to conduct pmCT especially in cases without consent to autopsy to gain information about possible causes of death and to rule out possible clinical errors.
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http://dx.doi.org/10.1186/s13049-016-0231-6 | DOI Listing |
Leg Med (Tokyo)
January 2025
Department of Forensic Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.
Porcine eyes were examined using postmortem computed tomography (PMCT) under controlled postmortem time and temperature conditions to assess the mechanisms and timing of changes in ocular structure. Eight porcine heads were halved, and PMCT scans were conducted from postmortem interval (PMI) days 0 to 13. CT images were obtained to evaluate the vitreous volumes, vitreous CT values, axial lengths of the eyes, lens dislocation, and intraocular gas.
View Article and Find Full Text PDFThe aim of this study is to investigate the potential of radiomic features extracted from postmortem computed tomography (PMCT) scans of the lateral cerebral ventricles (LCVs) to provide information on the time since death, or postmortem interval (PMI), a critical aspect of forensic medicine. Periodic PMCT scans, referred to as "sequential scans", were obtained from twelve corpses with known times of death, ranging from 5.5 to 273 h postmortem.
View Article and Find Full Text PDFTransl Cancer Res
November 2024
Mini-invasive Intervention Center, The Third Affiliated Hospital of the Naval Medical University, Shanghai, China.
Background: Hepatogastric fistula (HGF) is an uncommon occurrence that can be associated with various medical conditions. The primary causes typically involve peptic ulcer disease, infections (such as pyogenic, amoebic or tuberculosis), or iatrogenic factors (like post transarterial chemoembolization or radiotherapy). Massive gastrointestinal hemorrhage following HGF is extremely rare, with iodine-125 (I) seed migration to the stomach through HGF not previously documented.
View Article and Find Full Text PDFLeg Med (Tokyo)
February 2025
Department of Forensic Pathology and Science, Unit of Social Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address:
A common forensic problem is cervical fractures, which sometimes need to be diagnosed only by physical examination of the body, without imaging or autopsy. Despite reports from clinical practice describing the association between cervical fractures and head injury, we could not find any analysis of autopsy cases. In addition, discussion of the cervical fracture diagnosis by postmortem computed tomography (PMCT) appears limited.
View Article and Find Full Text PDFPathology
November 2024
Forensic Pathology Services, Victorian Institute of Forensic Medicine, Melbourne, Vic, Australia; Department of Forensic Medicine, Monash University, Vic, Australia. Electronic address:
The integration of postmortem computed tomography (PMCT) into forensic pathology practice has been the discipline's most important advance over the past 25 years. Likewise, postmortem radiological imaging has enhanced forensic neuropathology practice. The strengths and weaknesses of PMCT as applied to forensic neuropathology practice will be discussed.
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