Pub Date : 2019-11-28DOI: 10.1097/PAF.0000000000000521
Naoto Tani, Tomoya Ikeda, Alissa Shida, Yayoi Aoki, Kei Ikeda, F. Morioka, T. Ishikawa
The patient was a 5-year-old boy who was found in a state of cardiorespiratory arrest in the tub of a washing machine without water with the door closed. The autopsy findings included severe facial congestion and petechiae of the facial skin and palpebral conjunctiva. Several organs exhibited congestion. Hemorrhagic spots were seen on the serous membranes of various organs, with particularly marked hemorrhagic spots seen on the lungs. The heart contained fluid blood without soft clots. There were no findings indicative of marked trauma, intoxication, or hyperthermia. The examination results suggested that asphyxia had occurred in this case. However, there were no findings indicative of cervical compression, oronasal obstruction, or the presence of a foreign body in the respiratory tract. Image analysis showed the child could make postural changes inside the washing machine tub. Consequently, impaired thoracic movement and postural asphyxia were considered unlikely to have occurred. The results of blood gas analysis showed no evidence of marked hypercapnia. We, therefore, concluded that the cause of the child's death was asphyxia due to hypoxia caused by being in a closed space, that is, a washing machine tub.
{"title":"Case Report of an Autopsy of a Child Who Died in a Drum-Type Washing Machine Tub: Pathophysiology Resulting in Death and Assessment of Previous Literature.","authors":"Naoto Tani, Tomoya Ikeda, Alissa Shida, Yayoi Aoki, Kei Ikeda, F. Morioka, T. Ishikawa","doi":"10.1097/PAF.0000000000000521","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000521","url":null,"abstract":"The patient was a 5-year-old boy who was found in a state of cardiorespiratory arrest in the tub of a washing machine without water with the door closed. The autopsy findings included severe facial congestion and petechiae of the facial skin and palpebral conjunctiva. Several organs exhibited congestion. Hemorrhagic spots were seen on the serous membranes of various organs, with particularly marked hemorrhagic spots seen on the lungs. The heart contained fluid blood without soft clots. There were no findings indicative of marked trauma, intoxication, or hyperthermia. The examination results suggested that asphyxia had occurred in this case. However, there were no findings indicative of cervical compression, oronasal obstruction, or the presence of a foreign body in the respiratory tract. Image analysis showed the child could make postural changes inside the washing machine tub. Consequently, impaired thoracic movement and postural asphyxia were considered unlikely to have occurred. The results of blood gas analysis showed no evidence of marked hypercapnia. We, therefore, concluded that the cause of the child's death was asphyxia due to hypoxia caused by being in a closed space, that is, a washing machine tub.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87973886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-07DOI: 10.1097/PAF.0000000000000516
Suneeth F. Mathew, K. Kesha, S. Stables, P. Morrow, Charley Glenn, R. Tse
Ruptured esophageal varices can present as sudden death from gastrointestinal hemorrhage. The most common underlying pathology causing esophageal varices is cirrhosis leading to portal hypertension. However, not all esophageal varices arise from portal hypertension, and not all portal hypertensions are caused by cirrhosis. We present a rare case of ruptured esophageal varices casing death in an individual with metastatic tumor (high-grade) neuroendocrine tumor in the liver causing portal hypertension. This is, to the best of our knowledge, the first case report in the literature reporting a neuroendocrine tumor causing esophageal varices. This case report aims to document this rather rare entity, highlight another mechanism on how metastatic disease can result in sudden death, and give a brief review of literature on metastatic tumor in the liver causing esophageal varices.
{"title":"Ruptured Esophageal Varices From Metastatic Tumor in the Liver: A Case Report and Brief Review of Literature.","authors":"Suneeth F. Mathew, K. Kesha, S. Stables, P. Morrow, Charley Glenn, R. Tse","doi":"10.1097/PAF.0000000000000516","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000516","url":null,"abstract":"Ruptured esophageal varices can present as sudden death from gastrointestinal hemorrhage. The most common underlying pathology causing esophageal varices is cirrhosis leading to portal hypertension. However, not all esophageal varices arise from portal hypertension, and not all portal hypertensions are caused by cirrhosis. We present a rare case of ruptured esophageal varices casing death in an individual with metastatic tumor (high-grade) neuroendocrine tumor in the liver causing portal hypertension. This is, to the best of our knowledge, the first case report in the literature reporting a neuroendocrine tumor causing esophageal varices. This case report aims to document this rather rare entity, highlight another mechanism on how metastatic disease can result in sudden death, and give a brief review of literature on metastatic tumor in the liver causing esophageal varices.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"31 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79158829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-07DOI: 10.1097/PAF.0000000000000514
J. Schweigert, Rylee Christian, W. Kemp
A lingual abscess is a rare but potentially life-threatening disorder. Since the introduction of antibiotics, the incidence of posterior lingual abscesses has significantly declined; however, this condition is often missed on physical examination or misdiagnosed as another condition. The consequence of this misdiagnosis can be severe because airway obstruction with subsequent difficult or unattainable intubation can develop and lead rapidly to death. Being relatively rare yet potentially lethal, consideration of a lingual abscess at the time of autopsy is important; otherwise, it may be missed. During most autopsies, the base of the tongue is often examined grossly in a cursory fashion, if at all, and microscopic sections of this region are not commonly used. As this case report will illustrate, such an approach would most likely miss this important condition.
{"title":"Challenges in the Diagnosis of a Posterior Lingual Abscess, a Potential Lethal Disorder: A Case Report and Review of the Literature.","authors":"J. Schweigert, Rylee Christian, W. Kemp","doi":"10.1097/PAF.0000000000000514","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000514","url":null,"abstract":"A lingual abscess is a rare but potentially life-threatening disorder. Since the introduction of antibiotics, the incidence of posterior lingual abscesses has significantly declined; however, this condition is often missed on physical examination or misdiagnosed as another condition. The consequence of this misdiagnosis can be severe because airway obstruction with subsequent difficult or unattainable intubation can develop and lead rapidly to death. Being relatively rare yet potentially lethal, consideration of a lingual abscess at the time of autopsy is important; otherwise, it may be missed. During most autopsies, the base of the tongue is often examined grossly in a cursory fashion, if at all, and microscopic sections of this region are not commonly used. As this case report will illustrate, such an approach would most likely miss this important condition.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87492581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-31DOI: 10.1097/PAF.0000000000000507
Abdullah Avşar, Erdem Okdemir, Alper Keten, Ömer Kaya
The autopsy maintains its significance both forensically and medically despite enormous developments in antemortem and postmortem diagnostic methods. The present study probes the knowledge, attitude, and behavior of religious officials in our city toward autopsy and make an evaluation of how religion and culture affect those factors.The study consists of 219 Imams (male) and 69 Quran instructors (female) who serve in urban and rural regions of Kahramanmaras and approved informed consent forms.Two hundred thirty (79%) of the participants stated that the autopsy was an appropriate process according to Islam; 1 (0.3%) stated that it was inappropriate, whereas 57 (19.8%) were observed to have no idea regarding its appropriateness.The mean knowledge score that participants had about autopsy was determined to be 7.45 ± 1.73 (min = 1, max = 10).On the other hand, 240 participants (83.3%) stated that it was important for the religious officials to inform the society about the autopsy.The negative attitude toward autopsy stems from the lack of knowledge and traditions. The religious officials could help the doctors to change the negative attitude stemming from tradition toward the autopsy.
尽管在死前和死后诊断方法方面有了巨大的发展，但尸检在法医和医学上仍然具有重要意义。本研究探讨我市宗教官员对尸体解剖的知识、态度和行为，并评估宗教和文化对这些因素的影响。这项研究包括219名伊玛目(男性)和69名可兰经讲师(女性)，他们在Kahramanmaras的城市和农村地区服务，并批准了知情同意书。230名(79%)的参与者表示，根据伊斯兰教，尸检是一个适当的过程;1人(0.3%)表示不合适，57人(19.8%)不知道是否合适。被试对尸体解剖知识的平均得分为7.45±1.73 (min = 1, max = 10)。另一方面，240名(83.3%)受访者表示，宗教官员向社会通报尸体解剖的情况很重要。对尸体解剖的消极态度源于缺乏知识和传统。宗教官员可以帮助医生改变传统对尸检的消极态度。
{"title":"Religion, Culture, and Autopsy: A Survey With Muslim Religious Officials.","authors":"Abdullah Avşar, Erdem Okdemir, Alper Keten, Ömer Kaya","doi":"10.1097/PAF.0000000000000507","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000507","url":null,"abstract":"The autopsy maintains its significance both forensically and medically despite enormous developments in antemortem and postmortem diagnostic methods. The present study probes the knowledge, attitude, and behavior of religious officials in our city toward autopsy and make an evaluation of how religion and culture affect those factors.The study consists of 219 Imams (male) and 69 Quran instructors (female) who serve in urban and rural regions of Kahramanmaras and approved informed consent forms.Two hundred thirty (79%) of the participants stated that the autopsy was an appropriate process according to Islam; 1 (0.3%) stated that it was inappropriate, whereas 57 (19.8%) were observed to have no idea regarding its appropriateness.The mean knowledge score that participants had about autopsy was determined to be 7.45 ± 1.73 (min = 1, max = 10).On the other hand, 240 participants (83.3%) stated that it was important for the religious officials to inform the society about the autopsy.The negative attitude toward autopsy stems from the lack of knowledge and traditions. The religious officials could help the doctors to change the negative attitude stemming from tradition toward the autopsy.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79006592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-17DOI: 10.1097/PAF.0000000000000509
Erdem Okdemir, Alper Keten, Abdullah Avşar, Ömer Kaya
The materials used to produce shotgun ammunition can have different properties depending on the purpose, and ammunition can be fabricated or loaded manually. In Turkey, wheat-loaded cartridges are manufactured for use as sound cartridges. This ammunition is understood by the public to be harmless. However, we present a case of a 13-year-old adolescent boy who was wounded from a contact shot to the chest. An entrance wound measuring 7 cm and 5 cm in diameter was seen on the skin. Wheat grains could not be detected in the internal organs and were only observed between the chest muscles around the entrance wound. A plastic wad was also found in this area. The cause of death was internal bleeding due to internal organ injury. Wheat-loaded cartridges are not visible on x-ray and are difficult to detect visually in the wound.
{"title":"Death by Wheat-Loaded Cartridge: A Case Report.","authors":"Erdem Okdemir, Alper Keten, Abdullah Avşar, Ömer Kaya","doi":"10.1097/PAF.0000000000000509","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000509","url":null,"abstract":"The materials used to produce shotgun ammunition can have different properties depending on the purpose, and ammunition can be fabricated or loaded manually. In Turkey, wheat-loaded cartridges are manufactured for use as sound cartridges. This ammunition is understood by the public to be harmless. However, we present a case of a 13-year-old adolescent boy who was wounded from a contact shot to the chest. An entrance wound measuring 7 cm and 5 cm in diameter was seen on the skin. Wheat grains could not be detected in the internal organs and were only observed between the chest muscles around the entrance wound. A plastic wad was also found in this area. The cause of death was internal bleeding due to internal organ injury. Wheat-loaded cartridges are not visible on x-ray and are difficult to detect visually in the wound.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78662643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1097/PAF.0000000000000513
30 Erratum: Postmortem Hyperthermia: Two Case Reports and a Review of the Literature I n the December 2018 issue of The American Journal of Forensic Medicine and Pathology in the article by Franchi et al, “Postmortem Hyperthermia: Two Case Reports and a Review of the Literature,” the authors’ names were listed incorrectly. The names should read “Franchi A, Gauchotte G, Gambier N, Raul JS, Martrille L.” REFERENCE Franchi A, Gauchotte G, Gambier N, et al. PostmortemHyperthermia: Two Case Reports and a Review of the Literature. Am J Forensic Med Pathol. 2018;39: 364–366.
在2018年12月出版的《美国法医学与病理学杂志》上，Franchi等人发表的文章《死后热疗:两例病例报告和文献回顾》中，作者的名字被错误列出。这些名字应该读作“Franchi A, Gauchotte G, Gambier N, Raul JS, Martrille L.”参考francchi A, Gauchotte G, Gambier N等。死后热疗:两例报告及文献回顾。中华检验医学杂志，2018;39:364-366。
{"title":"Erratum: Postmortem Hyperthermia: Two Case Reports and a Review of the Literature.","authors":"","doi":"10.1097/PAF.0000000000000513","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000513","url":null,"abstract":"30 Erratum: Postmortem Hyperthermia: Two Case Reports and a Review of the Literature I n the December 2018 issue of The American Journal of Forensic Medicine and Pathology in the article by Franchi et al, “Postmortem Hyperthermia: Two Case Reports and a Review of the Literature,” the authors’ names were listed incorrectly. The names should read “Franchi A, Gauchotte G, Gambier N, Raul JS, Martrille L.” REFERENCE Franchi A, Gauchotte G, Gambier N, et al. PostmortemHyperthermia: Two Case Reports and a Review of the Literature. Am J Forensic Med Pathol. 2018;39: 364–366.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81679652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-13DOI: 10.1097/PAF.0000000000000496
R. Blumenthal, Pieter Evelyn Pienaar Scholtz, Jenna-Lee Shuttleworth
We present the case of a male adult who was admitted to an emergency department after having sustained envenomation from a black mamba (Dendroaspis polylepis). According to the available history, a single fang hooked his right index finger, post venom extraction. After administering antivenom in the accident and emergency department, further vials were transfused in the intensive care unit. An urticarial rash was noted, which was thought to be related to the antivenom. The victim remained in a coma for 3 days, after which he was declared dead. A medicolegal postmortem examination was performed 4 days after death because of logistical reasons. The complexities of differentiating acute envenomation from black mamba versus early acute reactions to polyvalent antivenom administration are highlighted in this case study.
{"title":"Black Mamba Death: Venom Versus Antivenom?","authors":"R. Blumenthal, Pieter Evelyn Pienaar Scholtz, Jenna-Lee Shuttleworth","doi":"10.1097/PAF.0000000000000496","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000496","url":null,"abstract":"We present the case of a male adult who was admitted to an emergency department after having sustained envenomation from a black mamba (Dendroaspis polylepis). According to the available history, a single fang hooked his right index finger, post venom extraction. After administering antivenom in the accident and emergency department, further vials were transfused in the intensive care unit. An urticarial rash was noted, which was thought to be related to the antivenom. The victim remained in a coma for 3 days, after which he was declared dead. A medicolegal postmortem examination was performed 4 days after death because of logistical reasons. The complexities of differentiating acute envenomation from black mamba versus early acute reactions to polyvalent antivenom administration are highlighted in this case study.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79999057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-01DOI: 10.1097/PAF.0000000000000295
Avneesh Gupta, Francisco J Diaz, A. Lal, Lokman Sung, C. Aaron
Diethylene glycol (DEG), an organic compound (HOCH2CH2)2O is a commonly used solvent. Mass poisoning outbreaks have been reported because of frequent contaminations. A PubMed search for diethylene resulted in 795 publications with 151 specifically discussing the toxicity. Of the 151 reported toxicity reviews/case reports, only 6 publications discussed the long-term neurological effects of diethylene toxicity. We report a fatal case of oral ingestion of DEG with complications from delayed toxicity. She died 7 days after the second admission. Autopsy disclosed a right basal ganglia hemorrhage within the brain and microscopic deposits of polarizable crystals into small cerebral blood vessels. Both kidneys illustrate tubular necrosis with scattered tubular deposition of polarizable calcium oxalate crystals. PubMed search leads to only 2 reported cases of basal ganglia hemorrhage (based on radiological findings) after ethylene glycol intoxication. Our case is the first reportable case of basal ganglia hemorrhage after DEG ingestion.
{"title":"Basal Ganglion Hemorrhage as Delayed Complication of Diethylene Glycol Ingestion.","authors":"Avneesh Gupta, Francisco J Diaz, A. Lal, Lokman Sung, C. Aaron","doi":"10.1097/PAF.0000000000000295","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000295","url":null,"abstract":"Diethylene glycol (DEG), an organic compound (HOCH2CH2)2O is a commonly used solvent. Mass poisoning outbreaks have been reported because of frequent contaminations. A PubMed search for diethylene resulted in 795 publications with 151 specifically discussing the toxicity. Of the 151 reported toxicity reviews/case reports, only 6 publications discussed the long-term neurological effects of diethylene toxicity. We report a fatal case of oral ingestion of DEG with complications from delayed toxicity. She died 7 days after the second admission. Autopsy disclosed a right basal ganglia hemorrhage within the brain and microscopic deposits of polarizable crystals into small cerebral blood vessels. Both kidneys illustrate tubular necrosis with scattered tubular deposition of polarizable calcium oxalate crystals. PubMed search leads to only 2 reported cases of basal ganglia hemorrhage (based on radiological findings) after ethylene glycol intoxication. Our case is the first reportable case of basal ganglia hemorrhage after DEG ingestion.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73877403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1097/PAF.0000000000000284
A. Verzeletti, C. Bonfanti, Anna Leide, Elena Azzalini, M. D. De Francesco, G. Piccinelli, F. De Ferrari
We report a fatal case of Waterhouse-Friderichsen syndrome in a 64-year-old man. The diagnosis, suspected during the autopsy (performed 63 hours after death), was confirmed through the successful detection of Streptococcus pneumoniae DNA and antigens in samples (blood and liver) collected during the autopsy. These results conformed with blood cultures performed antemortem, which became available only the day after the autopsy. The case underlines the need to collect biological material (liver and blood samples) during autopsy for microbiological investigations, although the collection is performed a long time after the death, suggesting that a liver sample works for DNA and liver and blood work for Streptococcus pneumoniae antigen detection.
{"title":"Streptococcus Pneumoniae Detection Long Time After Death in a Fatal Case of Waterhouse-Friderichsen Syndrome.","authors":"A. Verzeletti, C. Bonfanti, Anna Leide, Elena Azzalini, M. D. De Francesco, G. Piccinelli, F. De Ferrari","doi":"10.1097/PAF.0000000000000284","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000284","url":null,"abstract":"We report a fatal case of Waterhouse-Friderichsen syndrome in a 64-year-old man. The diagnosis, suspected during the autopsy (performed 63 hours after death), was confirmed through the successful detection of Streptococcus pneumoniae DNA and antigens in samples (blood and liver) collected during the autopsy. These results conformed with blood cultures performed antemortem, which became available only the day after the autopsy. The case underlines the need to collect biological material (liver and blood samples) during autopsy for microbiological investigations, although the collection is performed a long time after the death, suggesting that a liver sample works for DNA and liver and blood work for Streptococcus pneumoniae antigen detection.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85777578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1097/PAF.0000000000000276
L. Roquero, S. Camelo-Piragua, Carl J. Schmidt
Cerebral air embolism is a recognized life-threatening complication, sometimes iatrogenic. Its timely diagnosis is essential because it can result in neurologic deficits or death. We report a case of a 58-year-old man who died from cerebral air embolism diagnosed by nonenhanced computed tomography scan of the head after a cardiac bypass surgery with Biventricular Assist Device and multiple vascular line placements. Autopsy revealed extensive subcutaneous emphysema, intravascular and perivascular air bubbles in the central nervous system and associated cerebral and cerebellar hemorrhagic infarction. The autopsy was helpful in documenting the extent of the air embolism and its appearance in soft tissue and central nervous system.
{"title":"Cerebral Air Embolism: A Clinical, Radiologic and Histopathologic Correlation.","authors":"L. Roquero, S. Camelo-Piragua, Carl J. Schmidt","doi":"10.1097/PAF.0000000000000276","DOIUrl":"https://doi.org/10.1097/PAF.0000000000000276","url":null,"abstract":"Cerebral air embolism is a recognized life-threatening complication, sometimes iatrogenic. Its timely diagnosis is essential because it can result in neurologic deficits or death. We report a case of a 58-year-old man who died from cerebral air embolism diagnosed by nonenhanced computed tomography scan of the head after a cardiac bypass surgery with Biventricular Assist Device and multiple vascular line placements. Autopsy revealed extensive subcutaneous emphysema, intravascular and perivascular air bubbles in the central nervous system and associated cerebral and cerebellar hemorrhagic infarction. The autopsy was helpful in documenting the extent of the air embolism and its appearance in soft tissue and central nervous system.","PeriodicalId":7428,"journal":{"name":"American Journal of Forensic Medicine & Pathology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85051197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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