Gas at postmortem computed tomography – An evaluation of 73 non-putrefied trauma and non-trauma cases

Abstract Postmortem computed tomography (PMCT) has become an important complement in investigating forensic cases allowing an accurate detection of gas accumulations. The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-tra...

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Veröffentlicht in:Forensic science international 2012-10, Vol.222 (1), p.162-169
Hauptverfasser: Gebhart, Florin T.F, Brogdon, B.G, Zech, Wolf-Dieter, Thali, Michael J, Germerott, Tanja
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creator Gebhart, Florin T.F
Brogdon, B.G
Zech, Wolf-Dieter
Thali, Michael J
Germerott, Tanja
description Abstract Postmortem computed tomography (PMCT) has become an important complement in investigating forensic cases allowing an accurate detection of gas accumulations. The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-traumatic deaths. Furthermore the possibility of pneumobilia secondary to blunt abdominal trauma was studied. Retrospectively, 73 cases, underwent a whole-body PMCT prior to autopsy. These were divided into four groups: penetrating trauma (20 gunshot cases, 13 stabbing cases), blunt abdominal trauma (20 cases) and a control group of 20 non-trauma cases. Exclusion criteria were visible signs of decomposition. Each group was screened for gas accumulations in the vascular system, internal organs, soft tissues and body cavities. Gas accumulations were present in 98% of the trauma cases, compared to 80% of the control group. The most affected structures and/or organs in the trauma group were soft tissues, vessels and the liver. In most cases of the trauma group gas was associated with open injuries and lacerations of vessels. Furthermore, in the gunshot group gas was frequently seen in the intracranial cavity. Pneumobilia occurred in one case of the blunt trauma group; in that control group gas was also seen, but less frequently. Gas accumulation showed a strong association with traumatic events, but even the majority of non-trauma cases showed gas accumulations. Despite the exclusion of cases with visible decomposition signs, a putrefactive origin of gas was assumed in some cases. Gas accumulations are a frequent finding in PMCT with a higher incidence in (open) trauma cases. Even though a differentiation between putrefactive and traumatic gas accumulations is still difficult, knowledge of the circumstance surrounding the case may help identify the origin of gas.
doi_str_mv 10.1016/j.forsciint.2012.05.020
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The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-traumatic deaths. Furthermore the possibility of pneumobilia secondary to blunt abdominal trauma was studied. Retrospectively, 73 cases, underwent a whole-body PMCT prior to autopsy. These were divided into four groups: penetrating trauma (20 gunshot cases, 13 stabbing cases), blunt abdominal trauma (20 cases) and a control group of 20 non-trauma cases. Exclusion criteria were visible signs of decomposition. Each group was screened for gas accumulations in the vascular system, internal organs, soft tissues and body cavities. Gas accumulations were present in 98% of the trauma cases, compared to 80% of the control group. The most affected structures and/or organs in the trauma group were soft tissues, vessels and the liver. In most cases of the trauma group gas was associated with open injuries and lacerations of vessels. Furthermore, in the gunshot group gas was frequently seen in the intracranial cavity. Pneumobilia occurred in one case of the blunt trauma group; in that control group gas was also seen, but less frequently. Gas accumulation showed a strong association with traumatic events, but even the majority of non-trauma cases showed gas accumulations. Despite the exclusion of cases with visible decomposition signs, a putrefactive origin of gas was assumed in some cases. Gas accumulations are a frequent finding in PMCT with a higher incidence in (open) trauma cases. 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The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-traumatic deaths. Furthermore the possibility of pneumobilia secondary to blunt abdominal trauma was studied. Retrospectively, 73 cases, underwent a whole-body PMCT prior to autopsy. These were divided into four groups: penetrating trauma (20 gunshot cases, 13 stabbing cases), blunt abdominal trauma (20 cases) and a control group of 20 non-trauma cases. Exclusion criteria were visible signs of decomposition. Each group was screened for gas accumulations in the vascular system, internal organs, soft tissues and body cavities. Gas accumulations were present in 98% of the trauma cases, compared to 80% of the control group. The most affected structures and/or organs in the trauma group were soft tissues, vessels and the liver. In most cases of the trauma group gas was associated with open injuries and lacerations of vessels. 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The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-traumatic deaths. Furthermore the possibility of pneumobilia secondary to blunt abdominal trauma was studied. Retrospectively, 73 cases, underwent a whole-body PMCT prior to autopsy. These were divided into four groups: penetrating trauma (20 gunshot cases, 13 stabbing cases), blunt abdominal trauma (20 cases) and a control group of 20 non-trauma cases. Exclusion criteria were visible signs of decomposition. Each group was screened for gas accumulations in the vascular system, internal organs, soft tissues and body cavities. Gas accumulations were present in 98% of the trauma cases, compared to 80% of the control group. The most affected structures and/or organs in the trauma group were soft tissues, vessels and the liver. In most cases of the trauma group gas was associated with open injuries and lacerations of vessels. Furthermore, in the gunshot group gas was frequently seen in the intracranial cavity. Pneumobilia occurred in one case of the blunt trauma group; in that control group gas was also seen, but less frequently. Gas accumulation showed a strong association with traumatic events, but even the majority of non-trauma cases showed gas accumulations. Despite the exclusion of cases with visible decomposition signs, a putrefactive origin of gas was assumed in some cases. Gas accumulations are a frequent finding in PMCT with a higher incidence in (open) trauma cases. Even though a differentiation between putrefactive and traumatic gas accumulations is still difficult, knowledge of the circumstance surrounding the case may help identify the origin of gas.</abstract><cop>Kidlington</cop><pub>Elsevier Ireland Ltd</pub><pmid>22721934</pmid><doi>10.1016/j.forsciint.2012.05.020</doi><tpages>8</tpages></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals; ProQuest Central UK/Ireland
subjects Accumulations
Adult
Aged
Aged, 80 and over
Angiography
Autopsies
Biological and medical sciences
Blood Vessels - pathology
Brain - diagnostic imaging
Brain - pathology
Case-Control Studies
Computation
Decomposition
Emphysema - diagnostic imaging
Emphysema - pathology
Female
Forensic medicine
Forensic Pathology
Forensic radiology
Forensic sciences
Gases
General aspects
Humans
Investigative techniques, diagnostic techniques (general aspects)
Kidney - diagnostic imaging
Kidney - pathology
Liver - diagnostic imaging
Liver - pathology
Male
Medical sciences
Mesentery - diagnostic imaging
Mesentery - pathology
Middle Aged
Organs
Origins
Pancreas - diagnostic imaging
Pancreas - pathology
Pathology
Peritoneal Cavity - diagnostic imaging
Peritoneal Cavity - pathology
Pneumobilia
Postmortem Changes
Postmortem CT
Postmortem gas
Public health. Hygiene
Public health. Hygiene-occupational medicine
Retroperitoneal Space - diagnostic imaging
Retroperitoneal Space - pathology
Retrospective Studies
Soft tissues
Spinal Cord - diagnostic imaging
Spinal Cord - pathology
Spleen - diagnostic imaging
Spleen - pathology
Tomography
Tomography, X-Ray Computed
Virtopsy
Vital reaction
Whole Body Imaging
Wounds, Nonpenetrating - diagnostic imaging
Wounds, Nonpenetrating - pathology
Wounds, Penetrating - diagnostic imaging
Wounds, Penetrating - pathology
title Gas at postmortem computed tomography – An evaluation of 73 non-putrefied trauma and non-trauma cases
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